Key result
Oral P2Y12 inhibitors require further safety research despite increasing use in interventional neuroradiology.
Why the study?
The safety of prasugrel and ticagrelor in patients undergoing neurointerventional procedures remains a subject of discussion, with less cumulative experience than with clopidogrel and compared to cardiology.
Prasugrel and ticagrelor are potent alternatives for patients with clopidogrel resistance in interventional neuroradiology, but their increased bleeding risks necessitate tailored therapeutic strategies.
Requires bleeding vigilance with prasugrel or ticagrelor in neuroradiology; leaves open optimal strategies pending dedicated safety trials.
In the field of interventional neuroradiology, antiplatelet agents are commonly used to prepare patients before the implantation of permanent endovascular materials. Among the available drugs, clopidogrel is the most frequently used one, but resistance phenomena are considered to be relatively common. Prasugrel and ticagrelor were recently added to the pharmacologic arsenal, but the safety of these agents in patients undergoing neurointerventional procedures is still a subject of discussion. The cumulative experience with both drugs is less extensive than that with clopidogrel, and the experience with patients in the neurology field is less extensive than in the cardiology domain. In the present article, we provide a narrative review of studies that investigated safety issues of oral P2Y12 inhibitors in interventional neuroradiology and discuss potential routes for future research.
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Camargo et al. (2021) conducted a review in Patients undergoing neurointerventional procedures. Oral P2Y12 inhibitors (clopidogrel, prasugrel, ticagrelor) was evaluated. Oral P2Y12 inhibitors like prasugrel and ticagrelor are increasingly used in interventional neuroradiology, but their safety requires further research due to limited clinical experience.
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