Initial experiences with Multiplate® for rapid assessment of antiplatelet agent activity in neurosurgical emergencies

Aspirin in the perioperative period

“…Point-of-care tests may allow clinicians to determine patient compliance prior to undergoing surgery [62]. Conversely, ASA has been well marketed and available over the counter.…”

Point of care coagulation testing in neurosurgery

“…The Multiplate analyser GpIIb/IIIa = glycoprotein IIb/IIIa, PFA = platelet function analyser, TEG-PM = thrombelastography platelet mapping. was used in 22 patients with antiplatelet medication intake and conditions requiring urgent neurosurgical therapy [53,54]. Administration of haemostatic substances (desmopressin or tranexamic acid) and transfusion of platelet concentrates doubled platelet activity as measured by repeated Multiplate analysis.…”

Case Scenario: A Patient on Dual Antiplatelet Therapy with an Intracranial Hemorrhage after Percutaneous Coronary Intervention

“…45,46 However, 9 – 21% patients with ICH on admission demonstrate no platelet inhibition by functional assay despite a positive history of antiplatelet use. 47,48 In the absence of any demonstrable platelet dysfunction on the aspirin or P2Y 12 assays, platelet transfusions should be withheld. Withholding the platelet transfusion is of particular importance when the risk of ICH is weighed against the risk of major cardiovascular events during the ‘vulnerable’ non-endothelialized period following stent placement.…”