Dual antiplatelet therapy is currently used in clinical practice to prevent
thrombotic events during and after neuroendovascular procedures.
Despite antiplatelet therapy, a significant number of patients show insufficient platelet
inhibition, as measured by laboratory tests. These patients are at greater risk of
developing thrombotic events than are patients sensitive to the treatment. This
phenomenon is known as "antiplatelet drug resistance". The mechanisms that influence
the individual response to antiplatelet therapy are not completely understood and are
likely to be multifactorial.
Several platelet function tests have been developed to monitor antiplatelet therapy and
may assist in adjusting it to improve outcomes in patients with antiplatelet drug
resistance. Nevertheless, the optimal management for these patients has not yet been
established. This chapter summarizes information on the available antiplatelet drugs
currently used in neuroendovascular procedures, the commonly used tools for platelet
function testing and the potential mechanisms underlying suboptimal platelet inhibition
by aspirin and clopidogrel.
Keywords: Antiplatelet therapy, aspirin, neuroendovascular procedure, platelet
function test, P2Y12 receptor antagonists.
