Intravenous cangrelor use for neuroendovascular procedures : a two-center experience and updated systematic review
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..
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:14 |
|---|---|
| Enthalten in: |
Frontiers in neurology - 14(2023) vom: 01., Seite 1304599 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Desai, Harsh [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Anti-platelet therapy |
|---|
| Anmerkungen: |
Date Revised 21.12.2023 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.3389/fneur.2023.1304599 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM366067753 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM366067753 | ||
| 003 | DE-627 | ||
| 005 | 20231227135538.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231227s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.3389/fneur.2023.1304599 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1234.xml |
| 035 | |a (DE-627)NLM366067753 | ||
| 035 | |a (NLM)38116108 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Desai, Harsh |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Intravenous cangrelor use for neuroendovascular procedures |b a two-center experience and updated systematic review |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 21.12.2023 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a 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. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a anti-platelet therapy | |
| 650 | 4 | |a cangrelor | |
| 650 | 4 | |a endovascular | |
| 650 | 4 | |a stroke | |
| 650 | 4 | |a systematic review | |
| 700 | 1 | |a Al-Salihi, Mohammed Maan |e verfasserin |4 aut | |
| 700 | 1 | |a Morsi, Rami Z |e verfasserin |4 aut | |
| 700 | 1 | |a Vayani, Omar R |e verfasserin |4 aut | |
| 700 | 1 | |a Kothari, Sachin A |e verfasserin |4 aut | |
| 700 | 1 | |a Thind, Sonam |e verfasserin |4 aut | |
| 700 | 1 | |a Carrión-Penagos, Julián |e verfasserin |4 aut | |
| 700 | 1 | |a Baskaran, Archit |e verfasserin |4 aut | |
| 700 | 1 | |a Tarabichi, Ammar |e verfasserin |4 aut | |
| 700 | 1 | |a Bonderski, Veronica A |e verfasserin |4 aut | |
| 700 | 1 | |a Siegler, James E |e verfasserin |4 aut | |
| 700 | 1 | |a Hahn, Mary |e verfasserin |4 aut | |
| 700 | 1 | |a Coleman, Elisheva R |e verfasserin |4 aut | |
| 700 | 1 | |a Brorson, James R |e verfasserin |4 aut | |
| 700 | 1 | |a Mendelson, Scott J |e verfasserin |4 aut | |
| 700 | 1 | |a Mansour, Ali |e verfasserin |4 aut | |
| 700 | 1 | |a Dabus, Guilherme |e verfasserin |4 aut | |
| 700 | 1 | |a Hurley, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Prabhakaran, Shyam |e verfasserin |4 aut | |
| 700 | 1 | |a Linfante, Italo |e verfasserin |4 aut | |
| 700 | 1 | |a Kass-Hout, Tareq |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Frontiers in neurology |d 2010 |g 14(2023) vom: 01., Seite 1304599 |w (DE-627)NLM204500133 |x 1664-2295 |7 nnns |
| 773 | 1 | 8 | |g volume:14 |g year:2023 |g day:01 |g pages:1304599 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.3389/fneur.2023.1304599 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 14 |j 2023 |b 01 |h 1304599 | ||