platelet testing useful in CCSVI patients?

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

platelet testing useful in CCSVI patients?

Postby Cece » Fri Aug 31, 2012 8:52 am

Work done in our jugulars may be more prone to clotting than work done in other veins. Jugulars collapse in size when we are upright, limiting the flow. In some patients, flow is slow in the jugulars even after venoplasty, and that slow flow can contribute to clotting. PwMS may also have a tendency toward more coaguable blood.

So perhaps a platelet test should be used in CCSVI patients? I was reading about platelet testing here, although this was not in CCSVI patients:
http://www.medpagetoday.com/MeetingCove ... id=5517461
In the 798-patient MADONNA study, patients whose antiplatelet therapy was guided by a platelet function test had a nearly eight-fold decrease in risk of stent thrombosis versus controls, according to Jolanta Siller-Matula, MD, PhD, from the Medical University of Vienna, and colleagues.

The second study, RECLOSE-2 ACS, found that "global platelet reactivity," which tests for both clopidogrel and aspirin responsiveness, was able to identify a cohort of patients at increased risk.

The 9% of global nonresponders in the RECLOSE-2 ACS study had a significantly higher risk of cardiovascular ischemic events and cardiac death compared to those without a global high platelet reactivity, according to Rossella Marcucci, MD, of the University of Florence in Italy, and colleagues.

Antiplatelet drugs Clopidogrel and/or aspirin are sometimes prescribed after a CCSVI treatment or in combination with Pradaxa or an anticoagulant. If 9% of patients are nonresponders to Plavix or aspirin, that is a significant amount of people who would not be getting any anticoagulation or antiplatelet effect at all if only aspirin or Plavix is prescribed. Outcomes of clotting can include fully occluded jugular veins or pulmonary embolisms.

If a doctor prescribes only aspirin and/or Plavix, it might be a good idea to ask if platelet testing can be done, or to consider Pradaxa or other anticoagulants that work differently than the antiplatelets. Not meant as medical advice...
Cece
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