Eptifibatide桥接治疗颈动脉支架置入和心脏手术:安全性和可行性。

IF 1 4区 物理与天体物理 Q3 PHYSICS, MATHEMATICAL
Theoretical and Mathematical Physics Pub Date : 2024-04-01 Epub Date: 2022-03-26 DOI:10.1177/17085381221084813
M Travis Caton, Kazim H Narsinh, Amanda Baker, Matthew R Amans, Steven W Hetts, Joseph H Rapp, James C Ianuzzi, Elaine Tseng, Warren J Gasper, Daniel L Cooke
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引用次数: 0

摘要

背景预防性颈动脉支架术(CAS)是一种有效的策略,可减少需要心胸外科手术(CTS)的严重颈动脉狭窄患者围手术期卒中。在一次住院期间分期两种程序(CAS-CTS)对抗血小板治疗提出了相互冲突的需求,并且程序之间的最佳药物策略尚未确定。本研究的目的是介绍我们对阶段性CAS-CTS的“桥接”方案的初步经验。在单一转诊中心对阶段性CAS-CTS程序进行了ETHODSA回顾性审查。所有患者均患有多支冠状动脉和/或瓣膜疾病,颈动脉严重狭窄(>70%)。未服用阿司匹林的患者也在手术前开始服用阿司匹林,然后在CAS期间服用依非巴特(术中推注,然后术后输液,持续到手术早晨)。术前和围手术期(30天)神经系统发病率和死亡率是主要终点。结果采用该方案对10例患者进行了CAS手术。依非巴特桥接治疗的中位持续时间为36小时(范围24-288小时)。桥接和术后期间有1例轻微出血并发症(1/11,9.1%),无重大出血并发症。有一例术后非神经系统死亡,围手术期缺血性中风为零。结论对于接受分期CAS-CTS的患者,依替非肽桥接治疗是一种可行的临时抗血小板策略,具有良好的安全性。此策略使程序之间的时间间隔范围灵活。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Eptifibatide bridging therapy for staged carotid artery stenting and cardiac surgery: Safety and feasibility.

Background: Prophylactic carotid artery stenting (CAS) is an effective strategy to reduce perioperative stroke in patients with severe carotid stenosis who require cardiothoracic surgery (CTS). Staging both procedures (CAS-CTS) during a single hospitalization presents conflicting demands for antiplatelet therapy and the optimal pharmacologic strategy between procedures is not established. The purpose of this study is to present our initial experience with a "bridging" protocol for staged CAS-CTS.

Methods: A retrospective review of staged CAS-CTS procedures at a single referral center was performed. All patients had multivessel coronary and/or valvular disease and severe carotid stenosis (>70%). Patients not previously on aspirin were also started on aspirin prior to surgery, followed by eptifibatide during CAS (intraprocedural bolus followed by post-procedural infusion which was continued until the morning of surgery). Pre- and perioperative (30 days) neurologic morbidity and mortality was the primary endpoint.

Results: 11 CAS procedures were performed in 10 patients using the protocol. The median duration of eptifibatide bridge therapy was 36 h (range 24-288 h). There was one minor bleeding complication (1/11, 9.1%) and no major bleeding complications during the bridging and post-operative period. There was one post-operative, non-neurologic death and zero perioperative ischemic strokes.

Conclusions: For patients undergoing staged CAS-CTS, Eptifibatide bridging therapy is a viable temporary antiplatelet strategy with a favorable safety profile. This strategy enables a flexible range of time-intervals between procedures.

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来源期刊
Theoretical and Mathematical Physics
Theoretical and Mathematical Physics 物理-物理:数学物理
CiteScore
1.60
自引率
20.00%
发文量
103
审稿时长
4-8 weeks
期刊介绍: Theoretical and Mathematical Physics covers quantum field theory and theory of elementary particles, fundamental problems of nuclear physics, many-body problems and statistical physics, nonrelativistic quantum mechanics, and basic problems of gravitation theory. Articles report on current developments in theoretical physics as well as related mathematical problems. Theoretical and Mathematical Physics is published in collaboration with the Steklov Mathematical Institute of the Russian Academy of Sciences.
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