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Association of preprocedural antiplatelet use with decreased thromboembolic complications for intracranial aneurysms undergoing intrasaccular flow disruption.
Diestro, Jose Danilo Bengzon; Adeeb, Nimer; Musmar, Basel; Salim, Hamza; Aslan, Assala; Cancelliere, Nicole M; McLellan, Rachel M; Algin, Oktay; Ghozy, Sherief; Lay, Sovann V; Guenego, Adrien; Renieri, Leonardo; Carnevale, Joseph; Saliou, Guillaume; Mastorakos, Panagiotis; El Naamani, Kareem; Shotar, Eimad; Premat, Kevin; Möhlenbruch, Markus; Kral, Michael; Bernstock, Joshua D; Doron, Omer; Chung, Charlotte; Salem, Mohamed M; Lylyk, Ivan; Foreman, Paul M; Vachhani, Jay A; Shaikh, Hamza; Zupancic, Vedran; Hafeez, Muhammad U; Catapano, Joshua; Waqas, Muhammad; Ibrahim, Mohamed K; Mohammed, Marwa A; Imamoglu, Cetin; Bayrak, Ahmet; Rabinov, James D; Ren, Yifan; Schirmer, Clemens M; Piano, Mariangela; Kühn, Anna L; Michelozzi, Caterina; Elens, Stéphanie; Starke, Robert M; Hassan, Ameer E; Ogilvie, Mark; Nguyen, Anh; Jones, Jesse; Brinjikji, Waleed; Nawka, Marie T.
Afiliación
  • Diestro JDB; 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
  • Adeeb N; 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana.
  • Musmar B; 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana.
  • Salim H; 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana.
  • Aslan A; 2Department of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Shreveport, Louisiana.
  • Cancelliere NM; 1Division of Diagnostic and Therapeutic Neuroradiology, Department of Radiology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
  • McLellan RM; 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Algin O; 4Ankara University, Medical Faculty, Department of Radiology, Ankara, Turkey.
  • Ghozy S; Departments of5Radiology and.
  • Lay SV; 6Service de Neuroradiologie Diagnostique et Thérapeutique, Centre Hospitalier de Toulouse, Hôpital Purpan, Toulouse, France.
  • Guenego A; 7Service de Neuroradiologie Interventionnelle, Hôpital Universitaire Erasme, Bruxelles, Belgique.
  • Renieri L; 8Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
  • Carnevale J; 9Neurosurgery & Interventional Neuroradiology, NewYork-Presbyterian Hospital, Weill Cornell School of Medicine, New York, New York.
  • Saliou G; 10Service de radiodiagnostic et radiologie interventionnelle, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
  • Mastorakos P; 11Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
  • El Naamani K; 11Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania.
  • Shotar E; 12Département de Neuroradiologie, Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France.
  • Premat K; 12Département de Neuroradiologie, Hôpital Pitié-Salpêtrière, Université Sorbonne, Paris, France.
  • Möhlenbruch M; 13Sektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Germany.
  • Kral M; 14Department of Neurosurgery, Christian Doppler University Hospital and Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
  • Bernstock JD; 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Doron O; 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Chung C; Departments of15Radiology and.
  • Salem MM; 39Neurosurgery, NYU Langone Health Center, New York, New York.
  • Lylyk I; 16Department of Neurosurgery, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania.
  • Foreman PM; 17Equipo de Neurocirugía Endovascular y Radiología Intervencionista, Clínica La Sagrada Familia, Buenos Aires, Argentina.
  • Vachhani JA; 18Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida.
  • Shaikh H; 18Department of Neurosurgery, Orlando Health Neuroscience and Rehabilitation Institute, Orlando, Florida.
  • Zupancic V; Departments of19Radiology and.
  • Hafeez MU; 40Neurosurgery, Cooper University Health Care, Cooper Medical School of Rowan University, Camden, New Jersey.
  • Catapano J; 20Department of Radiology, Subdivision of Interventional Neuroradiology, Clinical Hospital Center Sisters of Mercy, Zagreb, Croatia.
  • Waqas M; 21Department of Neurosurgery, UTMB and Baylor School of Medicine, Houston, Texas.
  • Ibrahim MK; 22Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona.
  • Mohammed MA; 23Department of Neurosurgery, State University of New York at Buffalo, New York.
  • Imamoglu C; Departments of5Radiology and.
  • Bayrak A; 38Neurosurgery, Mayo Clinic, Rochester, Minnesota.
  • Rabinov JD; Departments of5Radiology and.
  • Ren Y; 38Neurosurgery, Mayo Clinic, Rochester, Minnesota.
  • Schirmer CM; 37Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey.
  • Piano M; 37Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital of the Ministry of Health, Ankara, Turkey.
  • Kühn AL; 3Neuroendovascular Program, Massachusetts General Hospital and Brigham and Women's Hospital, Harvard University, Boston, Massachusetts.
  • Michelozzi C; 24Department of Radiology, Interventional Radiology and Neurointerventional Services, Austin Health, Melbourne, Victoria, Australia.
  • Elens S; Departments of25Neurosurgery and.
  • Starke RM; 41Radiology, Geisinger Hospital, Danville, Pennsylvania.
  • Hassan AE; 26Interventistica Neurovascolare, Ospedale Niguarda Cà Granda, Milano, Italy.
  • Ogilvie M; 27Department of Neurointerventional Radiology, UMass Memorial Hospital, Worcester, Massachusetts.
  • Nguyen A; 28Interventistica Neurovascolare, Ospedale San Raffaele, Milano, Italy.
  • Jones J; 8Interventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
  • Brinjikji W; 29Deparment of Neurosurgery, University of Miami, Florida.
  • Nawka MT; 30Department of Neuroscience, Valley Baptist Neuroscience Institute, Harlingen, Texas.
J Neurosurg ; 141(4): 992-999, 2024 Oct 01.
Article en En | MEDLINE | ID: mdl-38701528
ABSTRACT

OBJECTIVE:

This study was conducted to investigate the impact of antiplatelet administration in the periprocedural period on the occurrence of thromboembolic complications (TECs) in patients undergoing treatment using the Woven EndoBridge (WEB) device for intracranial wide-necked bifurcation aneurysms. The primary objective was to assess whether the use of antiplatelets in the pre- and postprocedural phases reduces the likelihood of developing TECs, considering various covariates.

METHODS:

A retrospective multicenter observational study was conducted within the WorldWideWEB Consortium and comprised 38 academic centers with endovascular treatment capabilities. Univariable and multivariable logistic regression analyses were performed to determine the association between antiplatelet use and TECs, adjusting for covariates. Missing predictor data were addressed using multiple imputation.

RESULTS:

The study comprised two cohorts one addressing general thromboembolic events and consisting of 1412 patients, among whom 103 experienced TECs, and another focusing on symptomatic thromboembolic events and comprising 1395 patients, of whom 50 experienced symptomatic TECs. Preprocedural antiplatelet use was associated with a reduced likelihood of overall TECs (OR 0.32, 95% CI 0.19-0.53, p < 0.001) and symptomatic TECs (OR 0.49, 95% CI 0.25-0.95, p = 0.036), whereas postprocedural antiplatelet use showed no significant association with TECs. The study also revealed additional predictors of TECs, including stent use (overall OR 4.96, 95% CI 2.38-10.3, p < 0.001; symptomatic OR 3.24, 95% CI 1.26-8.36, p = 0.015), WEB single-layer sphere (SLS) type (overall OR 0.18, 95% CI 0.04-0.74, p = 0.017), and posterior circulation aneurysm location (symptomatic OR 18.43, 95% CI 1.48-230, p = 0.024).

CONCLUSIONS:

The findings of this study suggest that the preprocedural administration of antiplatelets is associated with a reduced likelihood of TECs in patients undergoing treatment with the WEB device for wide-necked bifurcation aneurysms. However, postprocedural antiplatelet use did not show a significant impact on TEC occurrence.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia / Inhibidores de Agregación Plaquetaria / Aneurisma Intracraneal / Procedimientos Endovasculares Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurosurg Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tromboembolia / Inhibidores de Agregación Plaquetaria / Aneurisma Intracraneal / Procedimientos Endovasculares Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurosurg Año: 2024 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Estados Unidos