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(Stroke. 2007;38:14.)
© 2007 American Heart Association, Inc.

Letters to the Editor

Role of Antiplatelets in Carotid Artery Stenting

Mercy Hospital and Medical Center, Chicago, Ill

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We would like to compliment the authors of the article "The Role of Antiplatelet Therapy in Carotid Stenting for Ischemic Stroke Prevention" by Drs Chatuvedi and Yadav.¹ They presented a much needed, comprehensive overview of the role of adjunct antiplatelet therapy in carotid artery stenting (CAS) and emphasized the proliferation of endovascular, stent-supported, carotid balloon angioplasty as a reasonable alternative to conventional surgery, carotid endarterctomy, in certain high-risk patients with both symptomatic and asymptomatic disease. Similarly, they projected, and we agree, this proliferation will soon supercede carotid endarterctomy surgery in the United States for stroke prevention because the numbers of trials have become extremely numerous since 2000.

The authors state that periprocedural dual antiplatelet therapy with aspirin (ASA) and clopidogrel has been accepted as the standard therapy in CAS mainly attributable to the experience gained in percutaneous coronary interventions in addition to the outcome noted in CARESS and CURE studies.^2,3 This has occurred despite the former study including only 108 patients, and the latter actually had nonstatistical significance in the stroke outcomes.

Two observations within this article captured our attention. The first was the authors’ mention of ASA+extended release dipyridamole (ER-DP) as almost an aside as an antiplatelet agent that may be used periprocedurally to have a positive impact on 24-hour and 30-day neurovascular events. We have recently performed an analysis of our patients who had CAS and received ASA+ER-DP. All were high risk (diabetic, hypertensive, and/or dyslipidemic) symptomatic patients. At the time of this writing, we . . . [Full Text of this Article]