Safety and efficacy of ticagrelor as single antiplatelet therapy in prevention of thromboembolic complications associated with the Pipeline Embolization Device (PED): multicenter experience
| Autor: | Ahmed Hegazy, Eman M. Khedr, Ahmed Shoyb, Christopher J Stapleton, Mahmoud H Mohammaden, Ahmed Elbassiouny, Stephen W. English |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Ticagrelor medicine.medical_specialty Subarachnoid hemorrhage medicine.medical_treatment Aneurysm Thromboembolism medicine Humans Prospective Studies cardiovascular diseases Embolization Prospective cohort study Aged Retrospective Studies business.industry Intracranial Aneurysm General Medicine Tirofiban Middle Aged medicine.disease Embolization Therapeutic Thrombosis Surgery Regimen Treatment Outcome Female Neurology (clinical) business Platelet Aggregation Inhibitors Follow-Up Studies medicine.drug |
| Zdroj: | Journal of NeuroInterventional Surgery. 12:1113-1116 |
| ISSN: | 1759-8486 1759-8478 |
| Popis: | BackgroundFlow diversion (FD) is a common treatment modality for complex intracranial aneurysms. A major concern regarding the use of FD is thromboembolic events (TEE). There is debate surrounding the optimal antiplatelet regimen to prevent TEE. We aim to evaluate the safety and efficacy of ticagrelor as a single antiplatelet therapy (SAPT) for the prevention of TEE following FD for complex aneurysm treatment.MethodsA retrospective review of a prospectively maintained neuroendovascular database at three endovascular centers was performed. Patients were included if they had an intracranial aneurysm that was treated with FD between January 2018 and September 2019 and were treated with ticagrelor as SAPT. Primary outcomes included early (within 72 hours post-procedure) and late (within 6 months) ischemic events.ResultsA total of 24 patients (mean age 47.7 years) with 36 aneurysms were eligible for analysis, including 15 (62.5%) females. 14 (58.3%) patients presented with subarachnoid hemorrhage. 35 aneurysms arose from the anterior circulation and 1 from the posterior circulation. 23 aneurysms had a saccular morphology, whereas 7 were fusiform and 6 were blister. For the treatment of all 36 aneurysms, 30 procedures were performed with 32 FD devices. Procedural in-stent thrombosis occurred in 2 cases and was treated with intra-arterial tirofiban without complications. Aneurysm re-bleeding was reported in 1 (4.2%) patient. There were no reported early or late TEE. Three patients discontinued ticagrelor due to systemic side effects.ConclusionTicagrelor is a safe and effective SAPT for the prevention of TEE after FD. Large multicenter prospective studies are warranted to validate our findings. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|