platelets

INTRODUCTION: The measurement of platelet inhibition (PI) level may be useful in quantifying the risk of thromboembolic complication in subjects undergoing endovascular treatment using implantable materials. We studied the predictability of the VerifyNow point-of-care assay in a large sample of consecutive neurointerventional procedures. METHODS: The percentage of P2Y12-inhibition was systematically measured in a total of 271 procedures (245 patients). The incidence of poor response and adverse events within the first 48 hours were recorded. RESULTS: The overall occurrence of poor response after a single loading-dose of clopidogrel of 300 mg was 61.3 % using a cut-off of 40 % and 43.9 % using a cut-off of 20 %. In the analysis of the incidence of adverse events by P2Y12-inhibition grouping, a significant association was observed between thromboembolic events and low response, with an overall incidence of 10.2 % (cut-off of 40 %) and 11.8 % (cut-off of 20 %). The assessment of predictability using different cut-offs showed that more than 90 % of thromboembolic events would be in the group of poor responders using a 40 % cut-off and more than 75 % using 20 %. CONCLUSION: The use of the VerifyNow assay in the neurointerventional context seems a valuable tool in the early detection of individuals at risk of peri-operative thromboembolic adverse events.