THE EFFECTS OF SHORT/LONG-TERM ADMINISTRATION OF DUAL ANTIPLATELET THERAPY ON RESTENOSIS IN PATIENTS WITH CAROTID ARTERY STENTING

Background: There is no consensus on the duration of dual antiaggregant therapy after carotid stenting. This study aimed to evaluate the early contribution of dual antiaggregant therapy for three or six months to stent restenosis. Objective: This study aimed to identify the correlation between stent restenosis and the duration of dual antiplatelet therapy (DAPT) in carotid artery stenting (CAS) subjects by retrospectively scanning a CAS procedure dataset. Methods: Patients who underwent a CAS procedure received dual DAPT (acetylsalicylic acid (ASA) + clopidogrel) were recruited for this study. The first group was the patients who received dual antiaggregants for three months, and the second group was the patients who received dual antiaggregants for six months. Patients' demographic characteristics, comorbidities, and radiological results were reviewed. Follow-up activities for the following six months were assessed for stent status, complications, and new ischemic lesions. Results: A total of 65 patients received ASA (acetylsalicylic acid) + clopidogrel for six months, while the remaining 118 patients were treated for three months. The restenosis rates were not significantly different between the two groups. The complication and adverse event frequencies were also similar. Conclusion: This study revealed that the efficacy of 3-month and 6-month DAPT is similar regarding the restenosis frequency, and there are no significant differences in complication frequency

Correlation between development of restenosis and duration of antiaggregant treatment in patients undergoing carotid stent implantation.

TEZ12869Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2017.Kaynakça (s. 85-96) var.X, 97 s. :_res. (bzs. rnk.), tablo ;_29 cm.Amaç: Bu çalışmada, karotis stent implantasyonu yapılan hastalarda ikili antiagregan tedavi süresinin prosedür sonrası dönemde 3 ay kullanımıyla, 6 ay kullanımının restenoz (stent içi trombozlar dahil) üzerine erken dönem sonuçlarını değerlendirmeyi amaçladık. Gereç ve yöntem: Çalışma, 2010 ve 2016 yılları arasında karotis stent implantasyonu yapılan, yaşları 51 ile 88 (ortalama 67) arasında değişen 77 (%32,5)’si kadın, 160 (%67,5)’i erkek olan toplam 237 hastanın retrospektif analiziyle yapıldı. Çalışmadaki hastalar, ikili antiagregan tedaviyi prosedür sonrası 3 ay veya 6 ay kullananlar ile verilen antiagregan tedavinin yetersiz olduğu kabul edilen (antiagregan direnci, uygun olmayan medikasyon, önerilen ilacı kullanmama) hastalar olmak üzere 3 ayrı gruba ayrıldı. Antiagregan medikasyon yetersizliği olanlar ayrıca değerlendirildikten sonra, ikili antiagregan tedaviyi 3 ay kullanan hastalarla, 6 ay kullanan hastaların takiplerinde restenoz (>%50 stenozlar anlamlı darlık kabul edildi) düzeylerinin istatistiksel analizi yapıldı. Bulgular: Hastaların 5 (%2,1)’inde antiagregan medikasyonu yetersiz olarak tespit değerlendirildi. İkili antiagregan tedavi 3 aya uzatılan 166 (%70), 6 aya uzatılan 66 (%27,8) hasta mevcuttu. Antiagregan tedavi medikasyonu yetersiz olarak değerlendirilen hastaların tamamında restenoz gözlendi (%100). İkili antiagregan tedavi 3 aya uzatılan hastaların 12 (%7,2) sinde, 6 aya uzatılanlarda 5 (%7,5) inde, medikasyon yetersizliği olanlarda 5 (%100) olmak üzere toplam 22 (%9,2) hastada restenoz saptandı. İstatistiksel analiz yapılırken antiagregan medikasyon yetersizliği olan 5 (%2,1) hasta dışlanarak yapıldı. İkili antiagregan tedaviyi 3 ay veya 6 ay alan iki hasta grubu ile restenoz arasında anlamlı farklılık olmadığı istatiksel olarak gösterildi (p>0,999). Ayrıca her iki grup arasında yeni gelişen nörolojik bulgular açısından ve kanama insidansı açısından farklılık olmadığı gözlendi. Sonuç: İkili antiagregan tedavi süresinin 3 ay kullanılmasıyla, 6 ay kullanılması arasında restenoz üzerine fark saptanmamıştır. İkili antiagregan süresini uzatmanın yeni gelişen iskemik komplikasyonlar veya kanama komplikasyonları üzerine farkı izlenmemiştir. Antiagregan medikasyonda asıl önemli olan, hasta uyumu ve antiagregan direnci gibi gözükmektedir. Bu verilerin daha geniş ve kapsamlı veri analizleriyle değerlendirilmesi gerekmektedir.Purpose: In this study, we aimed to evaluate that is there any correlation between the early results of restenosis (including in stent thrombosis) and post-procedural usage of dual antiaggregant theraphy for 3 or 6 months in patients undergoing carotid stent implantation. Materials and methods: The study was carried out retrospective analysis of patients between the years of 2010 and 2016, in which 77 (32.5%) female and 160 (67.5%) male, aged between 51 and 88 with carotid stent implantation. Patients in this study were divided into three groups: those who were treated dual antiaggregant therapy for 3 months, 6 months and considered to be inadequate. Statistical analysis of restenosis (> 50% stenosis, accepted as significant stenosis) was performed using dual antiaggregant medication for 3 months or 6 months after the antiagregant medication failure was evaluated separately. Results: İn five (2.1%) of the patients had inadequate antiagregan medication. There were 166 patients (70%) who were used for 3 months and 66 patients (27.8%) were used for 6 months. Restenosis was detected in 22 (%9,2) patients in totally, 12 (%7,2) patients of which were treated for 3 months, 5 (%7,5) patients were treated for 6 months, and 5 (%100) patients in the cases with antiagregan medication failure. Patients was out of statistical analysis who had story of inadequate antiaggregant treatment. There was no statistically significant difference between two groups of patients with different antiaggregant treatment times (p> 0,999). There was also no difference between the two groups in terms of new developed neurological findings and the incidence of bleeding. Conclusion: There was no difference in restenosis between 3 months of dual antiaggregant therapy and 6 months of using. There is no difference in development of new neurological findings or bleeding complications of using the duration of the dual antiaggregant therapy. The important thing in antiagregant medication, looks like patient adaptation and antiagregan resistance. These data need to be evaluated with more extensive and comprehensive data analysis