From the Research
The recommended duration of Clopidogrel (Plavix) therapy after an arterial dissection is at least 12 months, as indicated by the most recent and highest quality study 1. The standard dosage is 75 mg once daily following an initial loading dose of 300-600 mg. Treatment duration depends on several factors including the location and severity of the dissection, healing progress shown on follow-up imaging, and individual risk factors.
- For carotid or vertebral artery dissections, 3 months is often sufficient if healing is demonstrated, while other arterial dissections may require longer treatment.
- Plavix works by inhibiting platelet aggregation, which helps prevent thrombus formation at the dissection site that could lead to stroke or other complications.
- Common side effects include bleeding risk, bruising, and gastrointestinal issues.
- Patients should not stop taking Plavix without consulting their physician as premature discontinuation can increase risk of thrombotic events.
- Regular follow-up imaging is typically performed to assess healing and determine the appropriate time to discontinue therapy. It's worth noting that the use of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel for 12 months is a common approach, as supported by studies such as 2 and 1. However, the most recent study 1 suggests that aspirin and ticagrelor for 3 months, followed by aspirin and clopidogrel for the remaining duration, can be considered the optimal strategy for treating post-percutaneous coronary intervention patients with acute coronary syndrome. In the context of arterial dissection, the study 3 provides guidance on the use of antiplatelet therapy, recommending dual antiplatelet therapy (DAPT) consisting of aspirin and clopidogrel, and avoiding potent P2Y12 inhibitors. Overall, the decision on the duration of Clopidogrel therapy should be individualized based on the patient's specific condition and risk factors, and guided by the most recent and highest quality evidence available 1.