P2Y Reaction Units Threshold for Implementing Modified Antiplatelet Preparation in Coil Embolization of Unruptured Aneurysms: A Prospective Validation Study.

Purpose To identify and apply an optimized P2Y reaction units (PRU) threshold for implementing modified antiplatelet preparation to prevent thromboembolic events in patients nonresponsive to clopidogrel (clopidogrel nonresponders) undergoing coil embolization of unruptured aneurysms and to evaluate the clinical validity. Materials and Methods The optimal PRU threshold for prediction of thromboembolic events was determined with the Youden index in post hoc analysis of a previous, prospectively enrolled cohort of 165 patients in whom the antiplatelet regimen was not modified. This optimal PRU threshold was used to define clopidogrel nonresponders in a prospective validation study of 244 patients.

The role of estrogen on the pathology of cerebral aneurysms.

Introduction: Epidemiological studies suggest that postmenopausal estrogen deficiency is responsible for the increased risk of aneurysmal subarachnoid hemorrhage, while menopausal hormone therapy is protective against cerebral aneurysms. These findings indicate the critical role of estrogen in the pathophysiology of cerebral aneurysm.

Areas Covered: Here, we provide a narrative review for understanding the roles of estrogen and estrogen receptors in the pathogenesis of cerebral aneurysms.