Bleeding risks during angioplsty

  Can you comment on increased risks(if any) to a patient for cerebral bleeding
  during coronary angioplasty with the use of aspirin, heparin, and Ticlid
  alone or in combination.  The patient is 78 y.o. female with a history of an
  intracranial bleed four years ago.  The bleed was severe, but recovery
  was nearly complete with very little residual effects(slight weakness
  on affected side).  Does the angiplasty procedure subject such a patient
  to a significantly increased risk of suffering another ICH?  What if
  an aneurysm is present in the brain?  How would this procedure effect
  the likelihood that the aneursym would rupture during the procedure
  (ie the use of the medications above or possible increases in blood
  pressure during the procedure while on these meds).
  Thank you

[CCF Cardio MD - MTR]

Dear David, thank you for your question.  I'm not sure if you are pursuing litigation regarding the patient you mention in your question.  If you are, then this forum is not the appropriate place to have your questions answered.  However, I will add a few points.  Cerebral bleeding during angioplasty with aspirin, heparin, and ticlid is very uncommon (< 1% in multiple large-scale clinical trials).   Once an intracerebral bleed has occurred, a patient is always at risk for another bleed, but that risk is very complicated to assess.  Likewise, I really can't answer the question about the likelihood of an aneurysm rupturing during an angioplasty since I don't know the details of the procedure you mention.  My suggestion is that you speak with the patient's physicians regarding your questions.  
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