Low incidence of hemorrhagic complications both during and after surgical procedures in patients maintained on prasugrel single antiplatelet therapy

Khanafer, Ali; Cimpoca, Alexandru; Bhogal, Paul; Babiy-Pachomow, O.; Kurucz, Peter; Ganslandt, Oliver; Henkes, Hans

doi:10.1016/j.neurad.2022.03.004

Cited by 4 publications

(1 citation statement)

References 26 publications

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“…In this regard, studies on flow diversion using only a single anti-aggregant have shown interesting and promising results, with prasugrel showing a very good safety profile with a 3.9 % thromboembolic complication rate [45], in contrast to ASA, which resulted in a thromboembolic complication rate of approximately 20 % [46]. Using appropriate medication regimens, recent reports observed comparable outcomes for single anti-platelet therapy or dual anti-platelet therapy after FD [47,48,49]. However, the use is still off-label.…”

Section: Advancements In Flow Diversion Over the Past Decadementioning

confidence: 99%

Review: Flow Diversion for the Treatment of Middle Cerebral Artery Aneurysms

Schüngel,

Wohlgemuth,

Elolf

et al. 2024

Rofo

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The invention of flow diverting stents (FDS) is a novel milestone in the field of endovascular aneurysm therapy, promoting physiological healing of the vessel segment contrary to prior deconstructive treatment strategies, such as coiling. The effects of FDS are based on changes in flow patterns, segmental wall stabilization, and the growth of a neointima. Although flow diversion is already well established for cerebral aneurysms in proximal segments, peripheral locations remain challenging. Especially the middle cerebral artery (MCA) with its predominance of non-collateralized perforators and functional end arteries that supply the eloquent areas of the brain is of major concern.The literature was reviewed for flow diversion of the MCA and antiplatelet therapy.Resulting from the special anatomical characteristics of the MCA, FDS implantation in this territory is completely different from the proximal vessel segments. Still, flow diversion represents an effective endovascular strategy, especially in otherwise non-accessible or sufficiently treatable lesions. However, the risk of ischemic adverse events might be increased. Special attention to the individual decision regarding device selection, antiplatelet regimen, and exact definition of the proximal and distal landing zone considering the jailed side branches is essential for a good angiographic and clinical outcome.

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