Management of a patient requiring intrathecal drain insertion and removal in the setting of concomitant dual antiplatelet therapy with clopidogrel and aspirin: a case report.

Document Type

Article

Publication Date

6-1-2017

Institution/Department

Anesthesiology

Journal Title

A & A case reports.

MeSH Headings

Aspirin, Catheters, Indwelling, Clopidogrel, Device Removal, Drainage, Drug Therapy, Combination, Endovascular Procedures, Hematoma, Epidural, Spinal, Humans, Hydrocephalus, Intracranial Aneurysm, Intracranial Thrombosis, Male, Metals, Middle Aged, Platelet Aggregation Inhibitors, Prosthesis Design, Risk Factors, Stents, Subarachnoid Hemorrhage, Ticlopidine, Treatment Outcome

Abstract

We report a case of deliberate intrathecal catheter insertion and removal in the setting of continuous dual-antiplatelet therapy with clopidogrel and aspirin. A patient with recently sited bare metal intracerebral stents developed severe symptomatic hydrocephalus and required temporary cerebrospinal fluid diversion. The risks of intracerebral in-stent thrombosis or delayed intervention precluded following guidelines for the management of clopidogrel in neuraxial procedures. Options to mitigate the risk of and facilitate the early detection of epidural hematoma are discussed when neuraxial instrumentation is indicated in the setting of clopidogrel and aspirin therapy.

ISSN

2325-7237

First Page

279

Last Page

281

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