Hemorrhagic complications after prasugrel (Effient) therapy for vascular neurointerventional procedures.

Journal of Neurointerventional Surgery
S Hassan AkbariChristopher J Moran

Abstract

Dual antiplatelet therapy (DAPT) with aspirin and a thienopyridine (eg, clopidogrel) prevents stent related thromboembolic events in cardiac patients and is frequently utilized during neurointerventional surgery. However, recent data suggest that many patients exhibit clopidogrel resistance. Prasugrel-a newer thienopyridine-lowers the rate of cardiac stent thromboses in clopidogrel non-responders but a paucity of data exist regarding its safety and efficacy in neurointerventional surgery. All patients undergoing neurointerventional surgery by a single interventionalist (CJM) over a 20 month period were retrospectively identified. Charts were reviewed for pre- and post-procedural DAPT regimens, pre-procedural coagulation parameters and procedural complications. 76 patients received pre- and post-procedural DAPT for endovascular treatment of an intracerebral aneurysm, dural arteriovenous fistula or intra/extracranial arterial stenosis. 51 patients underwent 55 total procedures and were treated with aspirin/clopidogrel; 25 patients underwent 31 total procedures and were treated with aspirin/prasugrel. Those patients who received aspirin/prasugrel DAPT were identified pre-procedurally to be clopidogrel non-responders. Both treatmen...Continue Reading

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Citations

Jun 9, 2012·Journal of Neurointerventional Surgery·Thabele M Leslie-MazwiJoshua A Hirsch
Jun 14, 2013·Journal of Neurointerventional Surgery·Ronil V Chandra
Jun 14, 2013·Journal of Neurointerventional Surgery·Thabele M Leslie-Mazwi
Apr 29, 2014·Journal of Cardiovascular Translational Research·Rajan A G Patel
Sep 5, 2015·Clinical Neuroradiology·W ReithO Jansen
Jan 7, 2014·Journal of Neurointerventional Surgery·Ryan W F FaughtMichelle Janine Smith
Mar 25, 2014·Clinical Biochemistry·Radu M NanauManuela G Neuman
Nov 1, 2016·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Jacques SedatMichel Lonjon
May 9, 2013·Surgical Neurology International·Andrew S Ferrell, Gavin W Britz
Nov 6, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Radoslav RaychevGary Duckwiler
Mar 7, 2018·The British Journal of Radiology·Rajsrinivas ParthasarathyAditya Gupta
Dec 2, 2017·Journal of Neurosurgery·Keri S KimAaron M Cook
Nov 23, 2017·SAGE Open Medical Case Reports·Thomas KotsisErifyli Argyra
Sep 8, 2017·Journal of Pharmacy Practice·Elizabeth M OlafsonDavid D Leedahl
Jan 8, 2019·Acta Neurologica Scandinavica·Anthony LamannaHamed Asadi
Jul 18, 2014·Neurosurgery·Ajay K Wakhloo, Matthew J Gounis
Jul 25, 2014·Journal of Neurointerventional Surgery·Chirag D GandhiUNKNOWN SNIS Standards and Guidelines Committee
Jul 6, 2019·Journal of Neurointerventional Surgery·Anna PodlasekMohammed A Almekhlafi
Jul 8, 2016·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Michele B KaufmanMary Choy
Dec 28, 2017·Journal of Pharmacy Practice·Kyle Davis, Christopher Morrison
Mar 7, 2020·AJNR. American Journal of Neuroradiology·Christopher J Moran
Jan 12, 2019·Journal of Korean Neurosurgical Society·Ho Jun YiByoung Hun Lee
Nov 16, 2016·Anesthesiology and Pain Medicine·Yun Suk ChoeAe Ryoung Lee
Jun 6, 2019·Clinical Neuroradiology·Ismail OranFatih Duzgun

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