
School of Medicine Publications and Presentations
Document Type
Article
Publication Date
12-2023
Abstract
Objectives
Intravenous (IV) periprocedural antiplatelet therapy (APT) for patients undergoing acute carotid stenting during mechanical thrombectomy (MT) is not fully investigated. We aimed to compare the safety profile of IV low dose cangrelorversus IV glycoprotein IIb/IIIa (GP-IIb/IIIa) inhibitors in patients with acute tandem lesions (TLs).
Materials and methods
We retrospectively identified all cases of periprocedural administration of IV cangrelor or GP-IIb/IIIa inhibitors during acute TLs intervention from a multicenter collaboration. Patients were divided in two groups according to the IV APT regimen at the time of MT procedure: 1) cangrelor and 2) GP-IIb/IIIa inhibitors (tirofiban and eptifibatide). Safety outcomes included rates of symptomatic intracranial hemorrhage (sICH), parenchymal hematomatype 1 and 2 (PH1-PH2), and hemorrhagic infarction type 1 and 2 (HI1-HI2).
Results
Sixty-three patients received IV APT during MT, 30 were in the cangrelor group, and 33 were in the GP-IIb/IIIa inhibitors group. There were no significant differences in the rates of sICH (3.3% vs. 12.1%, aOR=0.21, 95%CI 0.02–2.18, p=0.229), HI1-HI2 (21.4% vs 42.4%, aOR=0.21, 95%CI 0.02–2.18, p=0.229), and PH1-PH2 (17.9% vs. 12.1%, aOR=1.63, 95%CI 0.29–9.83, p=0.577) between both treatment groups. However, there was a trend toward reduced hemorrhage rates with cangrelor. Cangrelor was associated with increased odds of complete reperfusion (aOR=5.86; 95%CI 1.57–26.62;p=0.013).
Conclusions
In this retrospective non-randomized cohort study, our findings suggest that low dose cangrelor has similar safety and increased rate of complete reperfusion compared to IV GP-IIb/IIIa inhibitors. Further prospective studies are warranted to confirm this association.
Recommended Citation
Jumaa, M. A., Rodriguez-Calienes, A., Dawod, G., Vivanco-Suarez, J., Hassan, A. E., Divani, A. A., ... & Ortega-Gutierrez, S. (2023). Low dose intravenous cangrelor versus glycoprotein IIb/IIIa inhibitors in endovascular treatment of tandem lesions. Journal of stroke and cerebrovascular diseases, 32(12), 107438. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107438
Publication Title
Journal of Stroke and Cerebrovascular Diseases
DOI
https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107438
Academic Level
faculty
Mentor/PI Department
Neurology
Comments
Original published version available at https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107438