Clopidogrel (also known as Plavix) is an antiplatelet drug, which means that it prevents blood cells called platelets from sticking together (aggregating) and forming blood clots
A platelet adenosine diphosphate receptor inhibitor.
Clopidogrel (Plavix, Bristol-Myers Squibb/Sanofi-Aventis) is a prodrug requiring hepatic metabolism by cytochrome P450 (CYP) isoenzymes to generate an active metabolite that is responsible for irreversible blocking of its target, the platelet adenosine diphosphate (ADP) P2Y12 receptor. Numerous investigations have demonstrated a broad interindividual variability in clopidogrel-induced antiplatelet effects. Notably, patients with high on-treatment platelet reactivity (HPR) have an increased risk of recurrent ischemic events, including stent thrombosis. Genetic and environmental factors modulating hepatic metabolism of clopidogrel have shown to significantly contribute to these findings.
Clopidogrel therapy is mandatory for six weeks after stenting to allow endothelialization.
● Prevention of intra-procedural and short-term post-procedural (4–12 weeks) thromboembolic events related to endovascular procedures including
○ Coil embolization of wide-neck cerebral aneurysms where stent will be used
○ Stent implantation (with a second antiplatelet agent)
○ Therapeutic occlusion of large arteries (often with a second antiplatelet agent)
● Subacute management of procedural complications (alone or in combination with a second agent)
○ Parent artery coil herniations
○ Thrombus or clot on coil phenomena
○ In-stent thrombus (may be more effective than other agents).