Clopidogrel Resistance and Embolism in Carotid Artery Stenting

Samsung Medical Center86 enrolled

Overview

The purpose of this study is to evaluate the efficacy and safety of the ticlopidine + ginko biloba compared to clopidogrel in clopidogrel resistant patients undergoing carotid artery stent placement. The investigators hypothesized that ticlopidine + ginko biloba is superior than clopidogrel in terms of post-stent ischemic lesions in these patients without serious complications.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Carotid Stenosis

Interventions

Ticlopidine + Ginko bilobaDRUG

ticlopidine hydrochloride 250mg, ginko leaf ext. 80mg, twice daily

ClopidogrelDRUG

clopidogrel bisulfate 97.875mg(75mg as clopidogrel)

Eligibility

Sex: ALLMin age: 20 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients scheduled for stent implantation due to carotid stenosis * Patients resistant to clopidogrel defined by platelet inhibition rate \<20% measured by Verify Now before carotid stenting * Patients with informed consent Exclusion Criteria: * Antiplatelet therapy other than aspirin, clopidogrel, or ticlopidine * Unable to perform MRI scans * Patients with hematologic abnormalities including neutrophil \<1500/ul, platelet \<100,000/uL, or AST/ALT \>120 U/L * Unsuitable for participation

Locations (1)

Oh Young Bang

Seoul, South Korea

RECRUITING

Outcomes

Primary Outcomes

New ischemic lesion on diffusion-weighted imaging (DWI)

Presence of new ischemic lesion in the ipsilesioinal hemisphere on DWI after carotid stening

Time frame: within 24 hours after carotid stenting

Secondary Outcomes

Number and Volume of new ischemic lesions on DWI

Time frame: within 24 hours after carotid stenting

Benign and malignant microembolic signals (MES) on transcranial Doppler (TCD)

Time frame: within 24 hours after carotid stenting

Ischemic stroke or transient ischemic attack (TIA)