Q:
My dentist is about to pull a tooth and wants me to replace Plavix for a certain period before and after surgery My dentist is about to pull a tooth and wants me to replace Plavix for a certain
period before and after surgery. What do you think?

A:

What is the risk / benefit ratio, especially in bleeding? " Answer: Professor Bousser recommends aspirin, except for persons who are at risk of bleeding, but otherwise it is advisable for those with a risk of clogged arteries that. Aspirin reduces the risk of migraines, which clog arteries, myocardial infarction and cerebral (and severity), limit the cancerous colon polyps, recurrent cancer, etc.. The recommended dose is 75 mg per day taken with meals. In CADASIL, bleeding risk is low. Increasingly, surgeons and dentists realize their interventions without asking to stop the aspirin. Plavix is ​​an antiplatelet, more expensive, which prevents platelets from sticking to the wall and arteries to clog. But it acts on platelets by a different route. It is recommended for people allergic to aspirin, or have a stomach ulcer. After myocardial infarction, cardiologists often prescribe a combination of the two most powerful treatments, aspirin and Plavix, but there is the side effect risk of bleeding. In CADASIL, the risk of cerebral hemorrhage is very low. But in CADASIL, when an artery gets blocked after a small infarct, it is unclear if a clot or if the artery is a spasm. When in doubt, it is not dangerous to take some aspirin. Surgeons do not like Plavix, some people are very sensitive and will bleed a lot, it is unpredictable. They are asking to stop this treatment five days before surgery, if there is a risk of bleeding. Paracetamol is an analgesic, it does not prevent arteries from clogging. Date: March 2012

CADASIL France General Meeting (www.CADASIL.com)

 

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