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March 15, 2023Journal of NeuroInterventional Surgery

Low dose intravenous cangrelor during neuroendovascular procedures was associated with a 4.9% rate of stent occlusion and a 2% rate of major hemorrhage at 24 hours.

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Why the study?

Dose-adjusted cangrelor based on platelet function testing has been suggested to be advantageous during neuroendovascular procedures, but its efficacy and safety required assessment.

Does low dose intravenous cangrelor prevent stent occlusion or persistent intraluminal thrombus in patients undergoing neuroendovascular procedures?

Population

101 consecutive patients undergoing neuroendovascular procedures for RIA, UIA, or AIS

Comparison

Low dose intravenous cangrelor

Design

Retrospective study

Follow-up

24 hours

Key result

Low dose intravenous cangrelor during neuroendovascular procedures was associated with a 4.9% rate of stent occlusion and a 2% rate of major hemorrhage at 24 hours.

Authors

FCFédérico CagnazzoRRRăzvan Alexandru RaduIDImad Derraz

Discussion

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Member takes

Overview

Low rates of occlusion and hemorrhage with low-dose cangrelor support further evaluation; leaves open efficacy confirmation in randomized neuroendovascular trials.

Study Design

Type

Cohort (n=101)

Structured PICO

Does low dose intravenous cangrelor prevent stent occlusion or persistent intraluminal thrombus in patients undergoing neuroendovascular procedures?

P
Population
101 patients (median age 59, 44.6% female) undergoing neuroendovascular procedures for intracranial aneurysms or acute ischemic stroke, treated with low dose cangrelor and assessed at 24 hours.
E
Exposure
Low dose intravenous cangrelor (5 µg/kg bolus; infusion 1 µg/kg/min)
O
Outcome
Rate of stent occlusion or persistent intraluminal thrombus (efficacy) and rate of major hemorrhages (safety) assessed at 24 hours by brain CT and CT angiographysafety

Low dose intravenous cangrelor appears effective for preventing stent thrombosis during neuroendovascular procedures with a low risk of major hemorrhage.

Cite This Study

Cagnazzo et al. (2023) conducted a cohort in Intracranial aneurysms and acute ischemic stroke (n=101). Low dose intravenous cangrelor was evaluated on Rate of stent occlusion or persistent intraluminal thrombus. Low dose intravenous cangrelor during neuroendovascular procedures was associated with a 4.9% rate of stent occlusion and a 2% rate of major hemorrhage at 24 hours.

synapsesocial.com/papers/6a81c63528bb6950eb6100b7https://doi.org/10.1136/jnis-2023-020094
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Safety of Low Dose Intravenous Cangrelor in Acute Ischemic Stroke: A Case Series2021 · 13 citations
  2. 2Use of cangrelor in neuroendovascular interventions: real-world evidence from a single-center cohort2026
  3. 3Intravenous cangrelor use for neuroendovascular procedures: a two-center experience and updated systematic review2023 · 12 citations
  4. 4Safety and efficacy of cangrelor in acute stenting for the treatment of cerebrovascular pathology: preliminary experience in a single-center pilot study2018 · 54 citations
  5. 5Cangrelor dose titration using platelet function testing during cerebrovascular stent placement2020 · 30 citations