- Clopidogrel Hyper-Response and Bleeding Risk in Neurointerventional Procedures
Patients may respond to antiplatelet medication in 2 ways: resistance leading to higher incidence of ischemic events and hyper-response resulting in bleeds. Here, 47 patients treated with clopidogrel were tested for P2Y12 receptor-mediated platelet inhibition. Clopidogrel hyper-response was more common in patients with major (n=10) than in those with minor bleeds. Of 7 patients defined as hyper-responders, 43% had major bleeding complications. Thus, hyper-response to clopidogrel is associated with increased risk of major hemorrhage. (See the related article by Comin and Kallmes.)
- Neuroradiology Critical Findings Lists: Survey of Neuroradiology Training Programs
These authors questioned neuroradiology fellowship programs about the availability of “critical findings” lists and, if available, how these are distributed to trainees and whether they were vetted by corresponding clinical departments. Over one-half of programs responded and 41% had such lists. The lists were distributed during orientation, sent or made available electronically, and posted in work areas. Less than 25% of lists were developed with input from other departments. The most common entities found in the lists were: brain hemorrhage, acute stroke, cord compression, brain herniation, and spine fracture.
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