Optimal pediatric dosing of anti-platelet agents for pipeline stent embolization -a case report and review of the literature.

Published

Journal Article (Review)

BACKGROUND: Various strategies are emerging for dosing antiplatelet therapies in preparation for pipeline stent embolization in adults. Hyper-response is associated with hemorrhagic complications. Hypo-response is associated with thromboembolic events. Dosing of antiplatelet agents is highly variable, with little consensus among experts for adults-and even more so for children. To date, pipeline stents have been deployed in 11 pediatric patients, ages 4-15. A variety of clopidogrel and aspirin dosing regimens have been used, with response tested in only three patients, who were all therapeutic. Thrombotic events occurred in two patients, neither of whom were tested. CASE: We describe here the first case of a hemorrhagic complication in a hyper-responsive pediatric patient undergoing placement of a pipeline stent. DISCUSSION: As the use of endovascular therapies requiring dual anti-platelet agents becomes more established, there is an increasing need to develop titration protocols that minimizes the risk of thrombotic and hemorrhagic events.

Full Text

Duke Authors

Cited Authors

  • Cobb, MI-PH; Zomorodi, AR; Hauck, EF; Smith, TP; Fernando Gonzalez, L

Published Date

  • April 2017

Published In

Volume / Issue

  • 33 / 4

Start / End Page

  • 685 - 690

PubMed ID

  • 27957634

Pubmed Central ID

  • 27957634

Electronic International Standard Serial Number (EISSN)

  • 1433-0350

Digital Object Identifier (DOI)

  • 10.1007/s00381-016-3311-z

Language

  • eng

Conference Location

  • Germany