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• W3136465733 abstract "Introduction: Mechanical Thrombectomy often requires immediate antiplatelet therapy when emergent stenting is needed. Intravenous cangrelor (CGR) is a potent reversible intravenous antiplatelet with a fast onset, a short half-life, and predictable pharmacokinetics. We sought to evaluate the safety and efficacy of this drug in MT patients. Methods: We performed a retrospective case control study at a CSC between 3/2016 and 4/2020. Patients who received intravenous CGR within 6 hours of admission (between 10/2019 - 4/2020) were compared with patients with anterior circulation tandem MCA occlusions who required stenting and oral antiplatelet therapy (between 3/16 - 10/19), prior to the availability of CGR at our facility. Results: We identified 35 patients, 12 of whom received IV CGR and 23 received acute oral antiplatelets for tandem occlusions. Average age of the cohort was 68.5 ± 13.4. Baseline characteristics including co-morbidities, rate of IV tPA, and time metrics were similar between the two groups. In the CGR group, nine patients had tandem anterior circulation occlusions, two had basilar occlusions, and one patient had an MCA occlusion secondary to severe stenosis. Eleven of the twelve patients in the CGR group required acute stenting. Intravenous CGR was used for an average of 20.2 hours after which patients were transitioned to aspirin and ticagrelor (33%) or clopidogrel (67%). Successful recanalization was achieved in all patients who received IV-CGR and in 95.7% of the tandem group. Final infarct volumes were comparable between the CGR and tandem cohorts (7.1 vs 15.5 ml; p=0.75). There were two cases of asymptomatic hemorrhage in both the CGR group and the tandem cohort, and one case of symptomatic ICH in the tandem cohort. Final functional outcomes (83.3% vs 60.9%; p=0.259) and mortality at three months (13% vs. 17%; p=1) were similar between the two groups. Conclusions: IV CGR is a promising medication for patients with acute ischemic stroke who require an immediate antiplatelet effect and is comparable in safety and efficacy to oral antiplatelets in the acute period of ischemic stroke. Larger prospective studies on the efficacy and safety of CGR in neurointervention are warranted." @default.
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• W3136465733 date "2021-03-01" @default.
• W3136465733 modified "2023-09-23" @default.
• W3136465733 title "Abstract P530: Safety of Intravenous Cangrelor in Acute Ischemic Stroke" @default.
• W3136465733 doi "https://doi.org/10.1161/str.52.suppl_1.p530" @default.
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