Giuseppe Pelle, Alessandro Onori, Flavio Andresciani, Massimo Messina, Alessandro Tanzilli, Ermanno Notarianni, Adelchi Saltarelli, Roberta Siniscalchi, Andrea Pietrantonio, Giada Toccaceli, Angelo Pompucci, Cesare Ambrogi
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引用次数: 0
Abstract
Purpose
This article aims to retrospectively assess the safety, efficacy and feasibility of using intravenous cangrelor in the acute treatment of small ruptured cerebral aneurysms (less than 6 mm) with FD, discussing its potential advantages over traditional antiplatelet agents and its implication on clinical practice.
Methods
This is a single-center retrospective study conducted on patients who underwent emergency FD implantation for hemorrhagic stroke due to acute rupture of intracranial aneurysms between January 2020 and February 2024. Patients were medicated with cangrelor in association with acetylsalicylic acid (ASA) before stent deployment. All patients were treated within 5 h from hospital arrival and received intravenous cangrelor (30 µg/kg administered over less than 1 min) + ASA (300 mg), followed by an infusion of cangrelor at 4 µg/kg/minute for either 12 or 24 h, as per clinical scenario. Procedural complications related to antiplatelet therapy itself, rate of complete aneurysm occlusion at 12-months follow-up and clinical outcome in terms of functional scale (mRS) were evaluated.
Results
Ten patients were retrospectively evaluated. The interventions showed a favorable outcome with no reported thromboembolic or hemorrhagic complications within the first 24 h post-procedure. Six out of ten patients (60%) of patients had a good clinical prognosis (mRS 0–2), and MRA/CTA follow-ups indicated a complete resolution of aneurysms in the majority of cases (five out of seven patients (71.5%) occlusion rate at 12 months).
Conclusion
In our limited experience, cangrelor has proven to be safe and effective in preventing thromboembolic complications after acute FD implantation for ruptured intracranial aneurysms; further studies with larger populations and comparative methodologies are required to incorporate cangrelor into standard neurovascular practice.
期刊介绍：
The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.
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