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- Title
The use of cangrelor in neurovascular interventions: a multicenter experience.
- Authors
Cortez, Gustavo M.; Monteiro, André; Sourour, Nader; Clarençon, Frédéric; Elhorany, Mahmoud; Grigoryan, Mikayel; Mirza, Soz; Dabus, Guilherme; Linfante, Italo; Aguilar-Salinas, Pedro; Murtaza, Yasmeen; Aghaebrahim, Amin; Sauvageau, Eric; Hanel, Ricardo A.
- Abstract
Purpose: Thromboembolic events represent the most common procedure-related complication associated with neurointerventions. Cangrelor is a potent, intravenous (IV), P2Y12-receptor antagonist with a rapid onset and offset presented as an alternative antiplatelet agent. We aim to evaluate the safety and effectiveness of IV cangrelor in neurovascular intervention. Methods: This is a retrospective analysis of data from four cerebrovascular interventional centers. We identified patients who underwent acute neurovascular intervention and received cangrelor as part of their optimum care. Patients were divided into 2 groups: ischemic and aneurysm. Periprocedural thromboembolic events, hemorrhagic complications, and outcomes were analyzed. Results: Sixty-six patients were included, 42 allocated into the ischemic group (IG), and 24 into aneurysm group (AG). The IG periprocedural symptomatic complication rate was 9.5%, represented by 3 postoperative intracranial hemorrhages and 1 retroperitoneal hematoma. At discharge, 47.6% had a favorable outcome and the mortality rate was 2.4%, related to clinical deterioration of a large infarct. In the AG, 4.2% had a periprocedural complication during or after cangrelor infusion, represented by an intracranial hemorrhage in an initially ruptured aneurysm. Favorable clinical outcome was seen in 56.2% and 87.7% of ruptured and unruptured aneurysms, respectively, upon discharge. Conclusions: Cangrelor may be a feasible alternative for patients requiring immediate intervention with the use of endoluminal devices. It allows the possibility for a secure transition to long-term ticagrelor and progression to surgery in the setting of unexpected complications.
- Subjects
DRUG dosage; THROMBOEMBOLISM prevention; RESEARCH; PERIOPERATIVE care; RETROPERITONEUM; NEUROLOGICAL disorders; CEREBRAL hemorrhage; HEMATOMA; NEUROTRANSMITTERS; MEDICAL cooperation; RETROSPECTIVE studies; SURGICAL complications; TREATMENT effectiveness; PLATELET aggregation inhibitors; PATIENT safety; EVALUATION
- Publication
Neuroradiology, 2021, Vol 63, Issue 6, p925
- ISSN
0028-3940
- Publication type
Article
- DOI
10.1007/s00234-020-02599-2