Rapid Decline of Cerebral Microemboli of Arterial Origin After Intravenous Acetylsalicylic Acid

Abstract

Background and Purpose-The present study investigated the influence of the antiplatelet agent acetylsalicylic acid (ASA) on cerebral microembolism as detected by transcranial Doppler sonography (TCD). Methods-Nine patients with recent transient ischemic attack or minor stroke of arterial origin were investigated. Eight had not received an antiplatelet or anticoagulant medication before TCD, and in 1 patient a preexisting ASA medication (100 mg/d) had not been changed since the onset of stroke symptoms. An initial 1-hour TCD monitoring was extended for an additional 2.5 hours after an intravenous bolus injection of 500 mg ASA and was repeated for 1 hour on the following day.

Cerebral Microembolism Is Blocked by Tirofiban, a Selective Nonpeptide Platelet Glycoprotein IIb/IIIa Receptor Antagonist

“…8 By its ability to bind factor VIIa, tissue factor directly activates the coagulation cascade with the generation of thrombin-a strong platelet activator-thereby linking plaque inflammation with arterial thromboembolism. The clinical relevance of these findings are illustrated by the observations of Goertler et al 21 that aspirin application resulted only in partially reduced MES rates. Since one dose of aspirin blocks, almost completely and for several days the platelet's ability to aggregate through the thromboxane pathway, reversibility of the MESblocking effect could not be examined.…”

A study of microemboli monitoring of atherosclerotic thrombotic cerebral infarction and artery stenosis

“…We believe that coronary heart disease has a similar etiology and risk factors with artery cerebral infarction, and the presence of coronary atherosclerosis indicated that the incidence of atherosclerosis increases in the neck and head. Studies have shown that antithrombotic treatments, such as antiplatelet, anticoagulant, and defibrinogen, could reduce the ratio of the detection of the first microemboli after stroke (Goertler et al, 1999). With registered large-scale clinical studies, such as the CARESS test (Markus and MacKinnon, 2005) and CLAIR test, we studied the effect of a clopidogrel and aspirin combination treatment on the prognosis of microembolus-positive patients.…”

Microemboli Monitoring in Ischemic Stroke

“…Glycoprotein IIb/IIIa receptor antagonist such as tirofiban infusion has shown to reduce the rate of microemboli and the effect was reversible with the cessation of infusion (Junghans and Siebler 2003). Administration of intravenous and oral acetylsalicyclic acid (ASA) has shown to reduce the frequency of microemboli rapidly (Goertler, Baeumer et al 1999;Goertler, Blaser et al 2001). Several small studies have shown that dual antiplatelet therapy might lead to rapid decline in microembolic frequency (Esagunde, Wong et al 2006).…”