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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Vascular Surgery

Advisor

Dr. Tom Colletti, DHSc, PA-C

Abstract

ABSTRACT

Purpose: The purpose of this article is to review the need for platelet function P2Y12 testing in the perioperative vascular setting to identify the possibility of clopidogrel resistance (CR), and thus allow for alternative antiplatelet prescribing options in order to prevent early and/or late onset stent thrombosis post revascularization.

Objective: To educate medical professionals concerning the importance for platelet function P2Y12 testing and how such testing correlates to endovascular interventional procedures. The goal is to improve the overall care for patients involved in endovascular intervention and to prevent early and/or late onset stent thrombosis.

Method: A Google Scholar and PubMed literature search were conducted with search terms, such as P2Y12 testing, Plavix resistance, vascular surgery, VerifyNow, and stent thrombosis. Utilizing both search engines, a combined total of 15 pertinent articles were retrieved and functioned as the basis for this clinical review.

Results: Several research studies postulate the correlation between patients determined to be hypo-/non-responsiveness to clopidogrel and subsequent thrombotic and/or ischemic events post endovascular revascularization with stent placement.

Conclusion: A common platelet P2Y12 receptor blocker, clopidogrel, is often utilized in patients undergoing percutaneous vascular stenting with the goal of preventing stent thrombosis and subsequent limb ischemia. Initiating routine perioperative P2Y12 platelet function testing would allow for clinicians to determine whether patients should be maintained on clopidogrel, or whether alternative antiplatelet medications, such as prasugrel and ticagrelor, should be implemented in order to prevent early and/or late onset stent thrombosis.

Keywords: P2Y12, Plavix, Vascular, Surgery, Angiogram, VerifyNow, Stent

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