Estimation of the perioperative management of stroke patients receiving antiplatelet therapy

Abstract

There is no direct evidence as to whether antiplatelet therapy should be discontinued or not when patients with cerebrovascular diseases undergo surgery or invasive examinations. We therefore examined the platelet aggregability as a marker for determining the adequate period to discontinue the antiplatelet agents. 22 patients who underwent surgery or examination were discontinued on antiplatelet agents (9 patients on aspirin and 13 patients on ticlopidine) for 14 days before the operation. The aggregability in the aspirin group was significantly increased on the 3^rd day as compared to that before the discontinuance (14.0±8.5% vs. 48.1±31.2%; p<0.05). The aggregability in the ticlopidine group was significantly increased on the 14^th day (19.5±11.4% vs. 58.4±30.8%; p<0.05). We conclude that it is desirable to pause aspirin for 3 days and ticlopidine for 2 weeks, in terms of the platelet aggregability.