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09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Adjunct bivalirudin dosing protocol for neuro-endovascular procedures.
Alexandros L Georgiadis1, Qaisar Shah, M Fareed K Suri
1Zeenat Qureshi Stroke Research Center, Department of Neurology, University of Minnesota.
Journal of Vascular and Interventional Neurology
|April 21, 2012
Summary
This study introduces a new bivalirudin dosing protocol for neuro-endovascular procedures. The proposed protocol aims for safe and effective anticoagulation by maintaining activated clotting time (ACT) within the target range.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Anticoagulation is crucial in neuro-endovascular procedures.
- Bivalirudin is a direct thrombin inhibitor with potential applications in this field.
Purpose of the Study:
- To propose and evaluate a novel bivalirudin dosing protocol for neuro-endovascular procedures.
- To assess the safety and efficacy of bivalirudin anticoagulation in this patient population.
Main Methods:
- Three distinct bivalirudin dosing regimens were tested in four patients.
- Activated clotting time (ACT) was continuously monitored.
- The target ACT range was set between 300-350 seconds.
Main Results:
- The initial protocols resulted in suboptimal ACT levels, either too high or too low.
- The third protocol demonstrated improved outcomes, with ACT within the therapeutic range for 72% of the monitoring time.
- ACT values did not exceed 366 seconds with the optimized protocol.
Conclusions:
- Bivalirudin dosing requires specific adjustments for neuro-endovascular interventions.
- A refined protocol shows promise for safe and effective anticoagulation.
- Further research is necessary to validate the long-term safety and efficacy of bivalirudin in these procedures.
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