Syracuse

Preliminary Experience with the Cangrelor for the Management of Antiplatelet Therapy in the Setting of Endovascular Treatment of Challenging Intracranial Aneurysms

Archive ouverte

Abdennour, Lamine | Sourour, Nader | Drir, Mehdi | Premat, Kévin | Shotar, Eimad | Taylor, Guillaume | Godier, Anne | Mathout, Jugurtha | Lenck, Stéphanie | Bernard, Remy | Carpentier, Alexandre | Degos, Vincent | Clarençon, Frédéric

Edité par CCSD ; Springer -

International audience. Background and Purpose:Cangrelor is a P2Y12 inhibitor that presents the advantage of having a short half-life. Its use may be helpful in the management of antiplatelet therapy for patients treated with stent assisted coiling or flow-diverter stents. The purpose of our study was to report our early experience in using cangrelor for such indications.Material and Methods:From October 2017 to November 2018, seven consecutive patients (5 females, 2 males, mean age = 56 y) were managed with cangrelor as antiplatelet therapy, combined with aspirin, for stent-assisted coiling embolizations and flow-diverter embolizations of challenging intra-cranial aneurysms. 71.4% (5/7) of the aneurysms were ruptured ones treated at the acute phase. In one case, the cangrelor was used as an alternative to clopidogrel in an asymptomatic hemorrhagic complication after stent assisted coiling to better control a possible worsening of the intracranial bleeding.Anti-aggregation protocols, including cangrelor, were systematically recorded.Results:One patient (14%) with a complex ruptured MCA aneurysm treated by flow diverter stent experienced a severe intracranial hemorrhage, which occurred after switching the cangrelor to ticagrelor and eventually lead to death. No hemorrhagic complication under cangrelor was recorded for the six remaining patients. No mRS shift was observed at discharge, except for the patient who died. Six out of the seven patients had a mRS ≤ 2 at follow-up.Conclusion:Cangrelor is a new anti-platelet therapy with a P2Y12 inhibiting effect, which is manoeuvrable, owing to its short half-life. This cases series present a pilot experience with promising results in terms of antiplatelet management for challenging intracranial aneurysms treated by stent assisted coiling or flow-diverter stents.

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Mémoire et thèse
• Gestion