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SNIS 20th annual meeting electronic poster abstracts
E-054 Intravenous cangrelor use for neuroendovascular procedures: a multicenter experience and updated systematic review
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  1. H Desai1,
  2. M Al-Salihi2,
  3. R Morsi1,
  4. O Vayani3,
  5. S Kothari1,
  6. S Thind1,
  7. J Carrión-Penagos1,
  8. A Baskaran1,
  9. A Tarabichi1,
  10. V Bonderski4,
  11. J Siegler5,6,
  12. M Hahn1,
  13. E Coleman1,
  14. J Brorson1,
  15. S Mendelson1,
  16. A Mansour1,
  17. G Dabus7,
  18. M Hurley1,
  19. S Prabhakaran1,
  20. I Linfante7,
  21. T Kass-Hout1
  1. 1Neurology, University of Chicago, Chicago, IL, USA
  2. 2Department of Neurological Surgery, University of Wisconsin, Madison, WI, USA
  3. 3Neurology, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA
  4. 4Pharmacy, University of Chicago, Chicago, IL, USA
  5. 5Cooper Neurological Institue, Cooper Health, Cherry Hill, NJ, USA
  6. 6Cooper Medical School of Rowan University, Camden, NJ, USA
  7. 7Neurology, Baptist Cardiac and Vascular Institute, Miami, FL, USA

Abstract

Introduction/Purpose The optimal antiplatelet therapy regimen for certain neuroendovascular procedures remains unclear. This study investigates the safety and feasibility of intravenous dose-adjusted cangrelor in patients undergoing acute neuroendovascular interventions.

Materials and Methods We conducted a retrospective chart review of all consecutive patients on intravenous cangrelor for neuroendovascular procedures between September 1, 2020, and March 13, 2022. PatientWe also conducted an updated systematic review and meta-analysis using PubMed, Scopus, Web of Science, Embase and the Cochrane Library up to February 22, 2023.

Results In our cohort, a total of 77 patients were included [mean age (years): 57.6 ± 18.3, males: 40 (51.9%), Black: 50 (64.9%)]. Cangrelor was most used for thrombectomy and stent placement (n=23, 29.9%). Approximately 25.0% of our patients had a favorable outcome with a modified Rankin Scale (mRS) score of 0 to 2 at 90 days (n=14/56); within 1 year, 12.8% of patients had recurrent or new strokes (n=6/47), 6.5% had symptomatic intracranial hemorrhage [sICH] (3/46), 4.3% had major extracranial bleeding events (2/47), and 2.1% had a gastrointestinal bleed (1/47). In our meta-analysis, 11 studies with 298 patients were included. The pooled proportion of sICH and intraprocedural thromboembolic complication events were 0.07 [95% CI 0.04 to 1.13] and 0.08 [9% CI 0.05 to 0.15], respectively.

Conclusions Our study found that intravenous cangrelor appears to be safe and effective in neuroendovascular procedures, with low rates of bleeding and ischemic events. However, further research is needed to compare different dosing and titration protocols of cangrelor and other intravenous agents.

Disclosures H. Desai: None. M. Al-Salihi: None. R. Morsi: None. O. Vayani: None. S. Kothari: None. S. Thind: None. J. Carrión-Penagos: None. A. Baskaran: None. A. Tarabichi: None. V. Bonderski: None. J. Siegler: None. M. Hahn: None. E. Coleman: None. J. Brorson: None. S. Mendelson: None. A. Mansour: None. G. Dabus: None. M. Hurley: None. S. Prabhakaran: None. I. Linfante: None. T. Kass-Hout: None.

https://doi.org/10.1136/jnis-2023-SNIS.154

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