Clopidogrel versus ticagrelor for antiplatelet therapy in transcarotid artery revascularization in the Society for Vascular Surgery Vascular Quality Initiative

Safety of Transcarotid Revascularization in Patients with a Contraindication to Dual Antiplatelets

“…A review of the available TCAR literature demonstrates several investigations comparing ticagrelor to clopidogrel in addition to aspirin, but not any that evaluates the efficacy and risk of single antiplateletbased regimens. [22][23][24] There are several limitations to this investigation which limits the overall strength of the findings. Because this is a retrospective analysis of a database and the associated medical records, variables can be missing or incomplete and are subject to the biases of the abstractors.…”

“…A review of the available TCAR literature demonstrates several investigations comparing ticagrelor to clopidogrel in addition to aspirin, but not any that evaluates the efficacy and risk of single antiplatelet-based regimens. 22-24…”

Optimal periprocedural antithrombotic treatment in carotid interventions: An international, multispecialty, expert review and position statement

“…[61][62][63] Recent studies have proposed the use of ticagrelor as one of the two antiplatelets agents instead of clopidogrel in DAPT (Table 3). [52][53][54] These early promising results with ticagrelor need to be verified in larger studies and RCTs. Future guidelines should aim at forming conclusive recommendations regarding the type and duration of antiplatelets/anticoagulants or DAPT in patients undergoing transfemoral CAS/TCAR.…”

“…51 Recent reports on CAS/TCAR have identified HTPR with clopidogrel as an important drawback and support the use of ticagrelor as an antithrombotic agent instead (Table 3). [52][53][54] An experimental study comparing the effects of clopidogrel vs. ticagrelor on post-balloon injury, in-stent restenosis and in-stent thrombosis in an atherosclerotic rabbit model undergoing carotid balloon injury ± CAS did not demonstrate any differences between the two antiplatelet agents. 55 Nevertheless, a drawback of ticagrelor as part of DAPT is its higher bleeding risk compared with clopidogrel.…”

“…55 Nevertheless, a drawback of ticagrelor as part of DAPT is its higher bleeding risk compared with clopidogrel. 53,54 Antiplatelet/antithrombotic treatment for patients with crescendo TIA/ stroke in evolution A crescendo TIA is defined as repetitive TIA episodes over hours or days followed by return to normal neurologic status. 56 In contrast, in patients with stroke in evolution there is progression of a neurologic deficit without restoration of neurologic status between episodes.…”