Use of cangrelor for complex percutaneous coronary intervention in the context of concomitant severe aortic stenosis: a case series.
Eur Heart J Case Rep
; 8(5): ytae237, 2024 May.
Article
em En
| MEDLINE
| ID: mdl-38774771
ABSTRACT
Background:
There is a growing need for percutaneous coronary intervention (PCI) to be performed within the same transcatheter aortic valve implantation (TAVI) procedure. In such cases, cangrelor, a fast-acting intravenous P2Y12-inhibitor with a short offset, is potential clinical utility to minimize bleeding and vascular complications during large-bore arterial access (LBAA) as well as the thrombotic risk associated with concomitant PCI. Casesummary:
We report two cases of TAVI with an indication to concomitant, high-risk PCI. In the first one, cangrelor was started only after LBAA was secured and TAVI completed, just before the initiation of complex PCI. In the second case, due to predicted complex coronary cannulation after TAVI, complex PCI was performed before TAVI and cangrelor started just after LBAA. In both cases, use of cangrelor (vs. pre-treatment with oral P2Y12-i) allowed for a tailored minimization of the risk of bleeding and vascular complications during LBAA while offering full platelet inhibition during a complex/high-risk PCI.Discussion:
In this case series, we illustrate a possible approach to the use of cangrelor for patients undergoing TAVI and complex/high-risk PCI. In such complex cases, thorough pre-procedural planning might include a cangrelor to minimize vascular, bleeding, and ischaemic complications.
Texto completo:
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Eur Heart J Case Rep
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Itália