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01-06-2021 | Ticagrelor | Interventional Neuroradiology

The use of cangrelor in neurovascular interventions: a multicenter experience

Authors: Gustavo M. Cortez, André Monteiro, Nader Sourour, Frédéric Clarençon, Mahmoud Elhorany, Mikayel Grigoryan, Soz Mirza, Guilherme Dabus, Italo Linfante, Pedro Aguilar-Salinas, Yasmeen Murtaza, Amin Aghaebrahim, Eric Sauvageau, Ricardo A. Hanel

Published in: Neuroradiology | Issue 6/2021

Abstract

Purpose

Thromboembolic events represent the most common procedure-related complication associated with neurointerventions. Cangrelor is a potent, intravenous (IV), P2Y12-receptor antagonist with a rapid onset and offset presented as an alternative antiplatelet agent. We aim to evaluate the safety and effectiveness of IV cangrelor in neurovascular intervention.

Methods

This is a retrospective analysis of data from four cerebrovascular interventional centers. We identified patients who underwent acute neurovascular intervention and received cangrelor as part of their optimum care. Patients were divided into 2 groups: ischemic and aneurysm. Periprocedural thromboembolic events, hemorrhagic complications, and outcomes were analyzed.

Results

Sixty-six patients were included, 42 allocated into the ischemic group (IG), and 24 into aneurysm group (AG). The IG periprocedural symptomatic complication rate was 9.5%, represented by 3 postoperative intracranial hemorrhages and 1 retroperitoneal hematoma. At discharge, 47.6% had a favorable outcome and the mortality rate was 2.4%, related to clinical deterioration of a large infarct. In the AG, 4.2% had a periprocedural complication during or after cangrelor infusion, represented by an intracranial hemorrhage in an initially ruptured aneurysm. Favorable clinical outcome was seen in 56.2% and 87.7% of ruptured and unruptured aneurysms, respectively, upon discharge.

Conclusions

Cangrelor may be a feasible alternative for patients requiring immediate intervention with the use of endoluminal devices. It allows the possibility for a secure transition to long-term ticagrelor and progression to surgery in the setting of unexpected complications.

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Title: The use of cangrelor in neurovascular interventions: a multicenter experience
Authors: Gustavo M. Cortez
André Monteiro
Nader Sourour
Frédéric Clarençon
Mahmoud Elhorany
Mikayel Grigoryan
Soz Mirza
Guilherme Dabus
Italo Linfante
Pedro Aguilar-Salinas
Yasmeen Murtaza
Amin Aghaebrahim
Eric Sauvageau
Ricardo A. Hanel
Publication date: 01-06-2021
Publisher: Springer Berlin Heidelberg
Keywords: Ticagrelor
Tirofiban
Stroke
Aneurysm
Aneurysm
Published in: Neuroradiology / Issue 6/2021
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-020-02599-2

At a glance: The STEP trials

Springer Medicine

The use of cangrelor in neurovascular interventions: a multicenter experience

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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