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Use of intravenous cangrelor and stenting in acute ischemic stroke interventions: a new single center analysis and pooled-analysis of current studies.
Paul, Alexandra R; Entezami, Pouya; Holden, Devin; Field, Nicholas; Dalfino, John; Boulos, Alan.
Afiliación
  • Paul AR; Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
  • Entezami P; Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
  • Holden D; Department of Pharmacy, Albany Medical Center, Albany, NY, USA.
  • Field N; Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
  • Dalfino J; Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
  • Boulos A; Department of Neurosurgery, Albany Medical Center, Albany, NY, USA.
Interv Neuroradiol ; 27(6): 837-842, 2021 Dec.
Article en En | MEDLINE | ID: mdl-33945341
ABSTRACT

INTRODUCTION:

Emergent stenting of both extra- and intracranial occlusions during acute ischemic stroke procedures is complicated by the need for immediate platelet inhibition to prevent thromboembolic complications. IV cangrelor is a relatively new antiplatelet that was initially approved for coronary interventions. Five prior case series have been published evaluating the results of IV cangrelor in neurointerventional procedures. We sought to combine the data from all prior studies and analyze only ischemic stroke interventions.

METHODS:

A prospectively maintained database was reviewed to identify all cases of IV cangrelor administration during acute ischemic stroke intervention. Nine additional patients were identified who have not been previously published. In addition, a literature search was performed to identify five prior publications of cangrelor in neurointervention. The data from these was combined with our institution in a pooled-analysis.

RESULTS:

Overall, 129 patients who received IV cangrelor during an acute ischemic stroke intervention were identified. The asymptomatic intracranial hemorrhage rate was 12.6%(11/87). The symptomatic intracranial hemorrhage rate was 6.2% (8/129). The rate of retroperitoneal hematoma and gastrointestinal bleeding were also low (1.5% and 0.8%, 2/129 and 1/129). There was one case of intraprocedural thromboembolic complication (0.8%) and no cases of intraprocedural in-stent thrombosis(0%).

CONCLUSIONS:

IV cangrelor during acute ischemic stroke intervention appears to be safe, with a symptomatic intracranial hemorrhage rate of 6.2%. More research is needed to determine the ideal dosing regimen.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Humans Idioma: En Revista: Interv Neuroradiol Asunto de la revista: NEUROLOGIA / RADIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Encefálica / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Límite: Humans Idioma: En Revista: Interv Neuroradiol Asunto de la revista: NEUROLOGIA / RADIOLOGIA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos
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