Application of thrombelastography in monitoring anti-platelet aggregation drugs in patients with intracranial aneurysms before stent-assisted embolization

Objective To investigate patients with intracranial aneurysms who will undergo stent-assisted embolization by thrombelastography (TEG) and provide references for the surgery． Methods One hundred and ninety-five patients admitted to Chinese PLA General Hospital from December 2012 to December 2014 who would undergo stent-assisted embolization were included in this study． They were divided into three groups according to their condition and doses of drugs． Patients with unruptured wide-necked aneurysms served as group A (n=75), and they took 100 mg of aspirin and 75 mg of clopidogrel every day． Splatelet inhibition rates induced by arachidonic acid (AA) and adenosine diphosphate (ADP) were detected at 1 d, 3 d, 5 d by TEG． Patients with ruptured aneurysms were randomly divided into group B (n=60) and group C (n=60)． Patients in group B took 200 mg of aspirin and 150 mg of clopidogrel every day． Splatelet inhibition rates were detected at 2 h, 12 h, 24 h, 36 h by TEG． Patients in group C took 300 mg of aspirin and 225 mg of clopidogrel on the day of admission． Splatelet inhibition rates were detected at 2 h, 8 h, 12 h, 24 h by TEG． Results There were significant differences in platelet inhibition ratios in group A when compared 1 d with 3 d (P< 0．05); And significant difference was also found in platelet inhibition ratios in group B when compared 2 h with 24 h (P< 0．05), and group C when compared 2 h with 8 h (P< 0．05)． Conclusion Patients with unruptured wide-necked aneurysms taking 100 mg of aspirin and 75 mg of clopidogrel before suegery can achieve a better platelet inhibition effect on 3 d after hospitalization． Patients with ruptured aneurysms taking 200 mg of aspirin and 150 mg of clopidogrel will achieve a better platelet inhibition effect on 24 hours after hospitalization． Patients with ruptured aneurysms taking 300 mg of aspirin and 225 mg of clopidogrel will achieve a better platelet inhibition effect on 8 hours after hospitalization． TEG can provide references for patients with intracranial aneurysm during stent-assisted embolization．