Perioperative dual antiplatelets management for ventriculoperitoneal shunt operation in patients with hydrocephalus after stent-assisted coil embolization of the ruptured intracranial aneurysm

Kim, Jang Hun; Choi, Jong‐il

doi:10.1016/j.clineuro.2020.106067

Cited by 5 publications

(2 citation statements)

References 30 publications

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“…Antiaggregant medications increase the risk of hemorrhagic complications associated with emergency surgery, such as cerebral fluid diversion, decompressive surgery, and parenchymal hematoma excavation. 18 Moreover, to resolve in-stent thrombosis, tirofiban administration may lead to rebleeding and the development of parenchymal hematomas that are both linked with the morbidity and mortality. 19 Bechan et al 16 suggested non-SAC techniques in the treatment of ruptured IAs because SAC is associated with increased morbidity and mortality rates.…”

Section: Discussionmentioning

confidence: 99%

Modified balloon-assisted coiling instead of acute stenting in the treatment of ruptured wide necked intracranial aneurysms

2022

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Background The aim of this study was to investigate the safety and efficiency of the modified balloon assisted coiling (mBAC) technique in endovascular treatment (EVT) of ruptured wide-necked aneurysms (WNAs) to avoid stent placement in the acute phase of subarachnoid hemorrhage (SAH). Methods The local neurointerventional radiology database was retrospectively reviewed to identify patients who underwent EVT due to ruptured WNAs by the authors. According to the EVT technique performed, the study sample was divided into 3 groups: conventional BAC, stent assisted coiling (SAC), and mBAC. The patient demographics, aneurysm features, technical and clinical complications, aneurysm occlusion grades, morbidity, and mortality rates were comparatively analyzed. Results This study involved a total of 113 patients who had ruptured WNAs. The mBAC technique was performed on 26 aneurysms (23 saccular and 3 fusiform) in 26 patients to avoid acute phase stenting. The mean continuous balloon inflation time was 7.1 ± 2.12 min. The initial and follow-up angiographic and clinical outcomes were better in the mBAC group than in the SAC group (p < 0.05). Conclusions The mBAC technique offers a prolonged, continuous balloon inflation time during the whole coiling process in the treatment of ruptured WNAs. The mBAC technique has the potential to obviate the need for SAC in patients who are candidates for stenting during the acute phase of SAH, and it might be considered a safe and effective endovascular approach with low complication rates and good angiographic and clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Modified balloon-assisted coiling instead of acute stenting in the treatment of ruptured wide necked intracranial aneurysms

2022

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“…In an in vivo study, 41 patients who underwent neurovascular stent placement and subsequently underwent ventriculoperitoneal shunt (VPS) surgical treatment allowing drainage of excess cerebrospinal fluid (CSF) from the ventricle into the abdomen, while on dual antiplatelet therapy, were divided into two groups; in the first group dual therapy was stopped and substituted with ibuprofen 0.6 g twice daily for five days, while in the second group dual therapy was maintained during surgery and assessment of risk factors for hemorrhagic complications was conducted for both groups. No observed ischemic complications in either group, while hemorrhagic complications were significantly more prevalent in the maintained dual therapy group in contrast to the dual therapy substituted by ibuprofen group, suggesting that ibuprofen can also be utilized as bridging therapy, which entails temporarily halting dual antiplatelet therapy for a five-day duration, Ensuring adequate time has passed since the last intake of ibuprofen minimizes the risk of hemorrhage, as any drug-induced platelet dysfunction can be effectively managed [63]. Moreover, even though platelet dysfunction is a concern for postoperative pain control with NSAIDs, still, administration of ibuprofen to patients undergoing supratentorial brain surgery led to pain relief and patient satisfaction comparable to morphine and paracetamol, without affecting the patients' blood platelet and clotting functions, as shown by the PFA-100 (platelet function analyzer) system, which is a platelet function analyzer designed to measure primary platelet-dependent homeostasis [64].…”

Section: Ibuprofen Effects On Plateletsmentioning

confidence: 95%

The Multifaceted Effects of Non-Steroidal and Non-Opioid Anti-Inflammatory and Analgesic Drugs on Platelets: Current Knowledge, Limitations, and Future Perspectives

Tsoupras,

Gkika,

Siadimas

et al. 2024

Pharmaceuticals

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Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most widely utilized pharmaceuticals worldwide. Besides their recognized anti-inflammatory effects, these drugs exhibit various other pleiotropic effects in several cells, including platelets. Within this article, the multifaceted properties of NSAIDs on platelet functions, activation and viability, as well as their interaction(s) with established antiplatelet medications, by hindering several platelet agonists’ pathways and receptors, are thoroughly reviewed. The efficacy and safety of NSAIDs as adjunctive therapies for conditions involving inflammation and platelet activation are also discussed. Emphasis is given to the antiplatelet potential of commonly administered NSAIDs medications, such as ibuprofen, diclofenac, naproxen and ketoprofen, alongside non-opioid analgesic and antipyretic medications like paracetamol. This article delves into their mechanisms of action against different pathways of platelet activation, aggregation and overall platelet functions, highlighting additional health-promoting properties of these anti-inflammatory and analgesic agents, without neglecting the induced by these drugs’ side-effects on platelets’ functionality and thrombocytopenia. Environmental issues emerging from the ever-increased subscription of these drugs are also discussed, along with the need for novel water treatment methodologies for their appropriate elimination from water and wastewater samples. Despite being efficiently eliminated during wastewater treatment processes on occasion, NSAIDs remain prevalent and are found at significant concentrations in water bodies that receive effluents from wastewater treatment plants (WWTPs), since there is no one-size-fits-all solution for removing all contaminants from wastewater, depending on the specific characteristics of the wastewater. Several novel methods have been studied, with adsorption being proposed as a cost-effective and environmentally friendly method for wastewater purification from such drugs. This article also presents limitations and future prospects regarding the observed antiplatelet effects of NSAIDs, as well as the potential of novel derivatives of these compounds, with benefits in other important platelet functions.

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Anticoagulation and Antiplatelet Treatments Related to Endovascular Treatment of Aneurysms

Ren

2022

Eight Aneurysms

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Perioperative dual antiplatelets management for ventriculoperitoneal shunt operation in patients with hydrocephalus after stent-assisted coil embolization of the ruptured intracranial aneurysm

Cited by 5 publications

References 30 publications

Modified balloon-assisted coiling instead of acute stenting in the treatment of ruptured wide necked intracranial aneurysms

Modified balloon-assisted coiling instead of acute stenting in the treatment of ruptured wide necked intracranial aneurysms

The Multifaceted Effects of Non-Steroidal and Non-Opioid Anti-Inflammatory and Analgesic Drugs on Platelets: Current Knowledge, Limitations, and Future Perspectives

Anticoagulation and Antiplatelet Treatments Related to Endovascular Treatment of Aneurysms

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