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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...

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Related Experiment Video

Updated: Jun 8, 2026

Magnetically-Assisted Remote Controlled Microcatheter Tip Deflection under Magnetic Resonance Imaging
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Cangrelor for neurointerventional procedures: A systematic review.

Nangorgo J Coulibaly1, Mohammed H Elgouhari1, Muhammad H Arshad1

  • 1Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|April 13, 2024
PubMed
Summary

Cangrelor, an intravenous P2Y12 inhibitor, shows promise for neurointerventional procedures due to its rapid action. This systematic review suggests it is safe and effective for acute ischemic strokes and aneurysms, though further trials are needed.

Keywords:
CangrelorNeurointerventionP2Y12 platelet inhibitoraneurysmstroke

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Area of Science:

  • Neurointerventional procedures
  • Pharmacology
  • Cardiovascular medicine

Background:

  • Thromboembolism is a risk in neurointerventions, necessitating antiplatelet therapy.
  • Current antiplatelet options have slow onset, delaying critical interventions.
  • Cangrelor offers immediate P2Y12 inhibition with a short half-life.

Purpose of the Study:

  • To evaluate the safety, effectiveness, and indications of Cangrelor in neurointerventional procedures.
  • To synthesize existing data on Cangrelor use in this patient population.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searched PubMed, Ovid Medline, and Embase databases through June 2023.
  • Included 17 studies involving 314 patients.

Main Results:

  • Most common indications: acute ischemic stroke (70%) and aneurysms (27.4%).
  • Common infusion: 30 μg/kg bolus and 4 µg/kg/min infusion (64.7%).
  • Hemorrhagic, thromboembolic, and death rates were 11.1%, 4.8%, and 8.6% respectively.

Conclusions:

  • Cangrelor is a potentially valuable P2Y12 inhibitor for neurointervention.
  • Its rapid onset is advantageous for acute settings.
  • Larger randomized trials are essential to confirm efficacy and safety.