PIG Meeting: 11th March 2021

Background

• On clopidogrel for history of TIA but had no formal diagnosis.
• Urology team requested to cease clopidogrel and replace with aspirin for perioperative period.
• Patient states he had previous urticaria and dyspnoea while on aspirin. Surgical team then suggested he commence aspirin and anti-histimine

Discussion

• Difficult to confirm diagnosis of TIA, no neurologist input
• No other CVS risk factors and previously ceased clopidogrel for other procedures
• Aspirin-exacerbated respiratory disease (AERD) and anaphylaxis to salicylates is not uncommon and should be taken seriously.

Plan

• Consensus that it is prudent to cease clopidogrel and not commence aspirin in this case given the soft indication
• Surgical commitment to ensuring the patient received adequate antiplatelet cover was noted and commended