Intravenous Dose-Adjusted Cangrelor Use for Neuroendovascular Procedures

Introduction: 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 neurovascular interventions.

Method(s): We conducted a retrospective chart review of all consecutive patients who underwent neuroendovascular procedures and were placed on intravenous cangrelor between September 1, 2020 and March 13, 2022. Cangrelor was administered as a 15 mcg/kg bolus followed by 2 mcg/kg/min infusion titrated to goal P2Y12 reaction unit (PRU) level of 50 to 150, and then transitioned to oral antiplatelet therapy. Demographic characteristics, interventional variables, and clinical outcomes were collected.

Result(s): During 1-year follow-up, approximately 4 patients had recurrent or new strokes (9.5%), 1 patient had in-stent thrombosis (2.9%) and 1 patient with symptomatic intracranial hemorrhage (2.4%), both while not on antiplatelet therapy, 2 patients with asymptomatic intracranial hemorrhage (4.8%).

Conclusion(s): To our knowledge, this is the first report to demonstrate the safety and effectiveness of intravenous cangrelor use titrated based on platelet function testing in the largest cohort of patients.

Publication History

Article published online:
09 February 2023