Use of cangrelor for complex percutaneous coronary intervention in the context of concomitant severe aortic stenosis: a case series.

Autor:	Soriano F; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy., Munafò AR; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy., Baydaroglu N; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy., Nava S; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy., Bruschi G; Cardiac Surgery, De Gasperis Cardio Center, Niguarda Hospital, Milan, Italy., Esposito G; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy., Oreglia JA; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy., Montalto C; Interventional Cardiology, De Gasperis Cardio Center, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy.; School of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, 20126 Milan, Italy.
Jazyk:	angličtina
Zdroj:	European heart journal. Case reports [Eur Heart J Case Rep] 2024 May 06; Vol. 8 (5), pp. ytae237. Date of Electronic Publication: 2024 May 06 (Print Publication: 2024).
DOI:	10.1093/ehjcr/ytae237
Abstrakt:	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. Case Summary: 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. Competing Interests: Conflict of interest: None declared. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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