AJDRAJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1778

INTERVENTIONAL

Platelet Aggregation in Intracranial Stents May Mimic In-Stent Restenosis

M. Mazighi, J.P. Saint Maurice, D. Bresson, Z. Szatmary and E. Houdart

From the Service de Neuroradiologie Diagnostique et Interventionnelle, Hopital Lariboisiere, Paris, France.

Please address correspondence to Emmanuel Houdart, MD, Service de Neuroradiologie Diagnostique et Interventionnelle, Hopital Lariboisiere, 2 rue Ambroise Paré, 75010 Paris, France; e-mail: emmanuel.houdart{at}lrb.aphp.fr

SUMMARY: We report the case of an early ISR that was due to platelet aggregation despite correct observance of a standard antiplatelet regimen. Biologic testing showed clopidogrel inefficiency, and ISR disappeared on angiography after a loading dose of clopidogrel. This result suggested that the arterial lumen reduction was due to platelet aggregation rather than in-stent myointimal hyperplasia. This observation emphasizes the importance of verifying the efficacy of clopidogrel before placing a stent.

Abbreviations: VASP, vasodilator-stimulated phosphoprotein






Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X