Action | Responses (No (%)) | Specific action |
---|---|---|
Double dose | 22 (43.1) | |
Change medication | 19 (37.3) | Prasugrel (n=11) Did not specify medication (n=8) Augment with IV Abciximab (n=3) Augment with intraoperative IA abciximab (n=1) Aggrenox (n=1) |
Re-bolus with Plavix 600 mg and recheck | 3 (5.88) | |
Ticreglor alone | 1 (1.96) | For PED cases |
Ignore and track outcomes | 1 (1.96) | |
Answer is not clear for neuroendovascular patients. A PRU <200 is associated with fewer adverse events in coronary stent population | 1 (1.96) | Action not specified |
Depends on inhibition testing | 1 (1.96) | If inhibition is <20%+Plavix 75 mg daily and repeat test in 4–7 days. If inhibition is 20–40% add Plavix 75 mg every other day, repeat P2Y12 test in 7 days |
Double dose and change medication | 1 (1.96) | Will often ‘double dose’ Plavix and recheck with VerifyNow, if PRU still >200, will switch to Effient |
Neuroform and Enterprise goal of PRU >50 and PRU <200; PED goal of PRU 50–150 | 1 (1.96) | Action not specified |
Increase dose, retest, and/or change medication and retest | 1 (1.96) | If close to therapeutic, increase Plavix dose and retest after 1–2 weeks; if little response to Plavix then switch to prasugrel 10 mg daily and retest after 1–2 weeks |
IA, intra-arterial; IV, intravenous; PED, pipeline embolization devices; PRU, P2Y12 reaction unit.