Cangrelor for neurointerventional procedures: A systematic review

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.