Intravenous cangrelor use for neuroendovascular procedures: a two-center experience and updated systematic review.

Autor:	Desai H; Department of Neurology, University of Chicago, Chicago, IL, United States., Al-Salihi MM; Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States., Morsi RZ; Department of Neurology, University of Chicago, Chicago, IL, United States., Vayani OR; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States., Kothari SA; Department of Neurology, University of Chicago, Chicago, IL, United States., Thind S; Department of Neurology, University of Chicago, Chicago, IL, United States., Carrión-Penagos J; Department of Neurology, University of Chicago, Chicago, IL, United States., Baskaran A; Department of Neurology, University of Chicago, Chicago, IL, United States., Tarabichi A; Department of Neurology, DENT Neurologic Institute, Amherst, NY, United States., Bonderski VA; Department of Pharmacy, University of Chicago, Chicago, IL, United States., Siegler JE; Department of Neurology, University of Chicago, Chicago, IL, United States., Hahn M; Department of Neurology, Stony Brook University Hospital, Stony Brook, NY, United States., Coleman ER; Department of Neurology, University of Chicago, Chicago, IL, United States., Brorson JR; Department of Neurology, University of Chicago, Chicago, IL, United States., Mendelson SJ; Department of Neurology, University of Chicago, Chicago, IL, United States., Mansour A; Department of Neurology, University of Chicago, Chicago, IL, United States., Dabus G; Department of Neurology, Baptist Cardiac and Vascular Institute, Miami, FL, United States., Hurley M; Department of Radiology, University of Chicago, Chicago, IL, United States., Prabhakaran S; Department of Neurology, University of Chicago, Chicago, IL, United States., Linfante I; Department of Neurology, Baptist Cardiac and Vascular Institute, Miami, FL, United States., Kass-Hout T; Department of Neurology, University of Chicago, Chicago, IL, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in neurology [Front Neurol] 2023 Dec 05; Vol. 14, pp. 1304599. Date of Electronic Publication: 2023 Dec 05 (Print Publication: 2023).
DOI:	10.3389/fneur.2023.1304599
Abstrakt:	Background: The optimal antiplatelet therapy regimen for certain neuroendovascular procedures remains unclear. This study investigates the safety and feasibility of intravenous dose-adjusted cangrelor in patients undergoing acute neuroendovascular interventions. Methods: We conducted a retrospective chart review of all consecutive patients on intravenous cangrelor for neuroendovascular procedures between September 1, 2020, and March 13, 2022. We also conducted an updated systematic review and meta-analysis using PubMed, Scopus, Web of Science, Embase and the Cochrane Library up to February 22, 2023. Results: In our cohort, a total of 76 patients were included [mean age (years): 57.2 ± 18.2, males: 39 (51.3), Black: 49 (64.5)]. Cangrelor was most used for embolization and intracranial stent placement ( n  = 24, 32%). Approximately 44% of our patients had a favorable outcome with a modified Rankin Scale (mRS) score of 0 to 2 at 90 days ( n  = 25/57); within 1 year, 8% of patients had recurrent or new strokes ( n  = 5/59), 6% had symptomatic intracranial hemorrhage [sICH] (4/64), 3% had major extracranial bleeding events (2/64), and 3% had a gastrointestinal bleed (2/64). In our meta-analysis, 11 studies with 298 patients were included. The pooled proportion of sICH and intraprocedural thromboembolic complication events were 0.07 [95% CI 0.04 to 1.13] and 0.08 [95% CI 0.05 to 0.15], respectively. Conclusion: Our study found that intravenous cangrelor appears to be safe and effective in neuroendovascular procedures, with low rates of bleeding and ischemic events. However, further research is needed to compare different dosing and titration protocols of cangrelor and other intravenous agents. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Desai, Al-Salihi, Morsi, Vayani, Kothari, Thind, Carrión-Penagos, Baskaran, Tarabichi, Bonderski, Siegler, Hahn, Coleman, Brorson, Mendelson, Mansour, Dabus, Hurley, Prabhakaran, Linfante and Kass-Hout.)
Databáze:	MEDLINE
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