|
KMID : 1201420230160010034
|
|
Journal of Neurocritical Care
2023 Volume.16 No. 1 p.34 ~ p.38
|
|
|
Ticagrelor washout bridged with GPIIb/IIIa inhibitor infusion to facilitate surgical care following placement of pipeline flow diverters: a case report
|
|
Aaron Zweig
James S Stanley
Ronak Patel
John Agola
Michael R Halstead
|
|
|
Abstract
|
|
|
Background: Pipeline flow diverters (PFDs) are becoming increasingly common. Antiplatelet medication is required to minimize periprocedural ischemic events. Short-acting GPIIb/IIIa inhibitors are frequently administered intraprocedurally; however, the role of these agents in postprocedural PFD management in the neurocritical care unit (NCCU) has been overlooked.
Case Report: A patient with an unruptured internal carotid artery aneurysm presented for PFD placement. PFD placement was complicated by post-procedure intra-PFD thrombosis and hemispheric ischemia. Aspirin and ticagrelor were restarted, and the surgery department consulted for tracheostomy and percutaneous endoscopic gastrostomy-tube placement. Short-half-life GPIIb/IIIa infusions served as bridges to surgery after aspirin and tirofiban washout.
Conclusion: NCCU management of complications of PFD placement remains under-researched. The use of long-acting antiplatelet agents post-PFD limits the safe administration of surgical procedures. Bridging with GPIIb/IIIa infusion may facilitate the safe delivery of intensive care in these cases.
|
|
|
KEYWORD
|
|
|
Half-life, Platelet aggregation inhibitors, Thrombosis, Aneurysm, Ischemia, Stents
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|