Platelet Aggregometry May Not Identify Clopidogrel-Treated Patients at High Risk of Peri-Operative Bleeding in Dialysis Access Surgery: A Pilot StudyBenjamin S Martinez1*, Irina Gasanova1, Adebola O Adesanya1, Ingemar Davidson2 and Ravindra Sarode3
- *Corresponding Author:
- Benjamin Seth Martinez
Assistant Professor of Anesthesiology
University of Texas Southwestern Medical Center, Texas, USA, 75390-9068
E-mail: [email protected]
Received date: July 23, 2012; Accepted date: August 11, 2012; Published date: August 21, 2012
Citation: Martinez BS, Gasanova I, Adesanya AO, Davidson I, Sarode R (2012) Platelet Aggregometry May Not Identify Clopidogrel-Treated Patients at High Risk of Peri-Operative Bleeding in Dialysis Access Surgery: A Pilot Study. J Anesth Clin Res 3:230. doi: 10.4172/2155-6148.1000230
Copyright: © 2012 Martinez BS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Patients treated with Clopidogrel are usually instructed to discontinue treatment for 7 days prior to surgery because of concern for excessive peri-operative blood loss. Limited data exist regarding blood loss resulting from continuing treatment with Clopidogrel. Our goal was to compare peri-operative blood loss in Clopidogrel (CC) treated patients with Non-Clopidogrel (NC) patients undergoing upper extremity dialysis access surgery. Methods: Following informed consent, 23 patients, 18-90 years old were enrolled in a pilot, prospective study. Nine patients continued treatment with Clopidogrel, while 14 patients had no exposure to the drug. Vascular fistula or graft placement was accomplished under brachial plexus anesthesia and sedation. ADP (adenosine diphosphate) induced inhibition of platelets was assayed by Impedance-based Whole Blood Platelet Aggregation (IWBPA) on immediate preoperative blood sample obtained from all participants to determine baseline platelet aggregation status (Figure 1). Intra-operative blood loss (IBL) was estimated from suction canister output and sponge weights. Interventions such as blood or blood product transfusion were noted. Postoperative bruising or bleeding for up to 24 hours was recorded.