The Impact of Preprocedural Platelet Function Testing on Periprocedural Complication Rates Associated With Pipeline Flow Diversion: An International Multicenter Study.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Vranic Justin E, Dmytriw Adam A, Berglar Inka K, Alotaibi Naif M, Cancelliere Nicole M, Stapleton Christopher J, Rabinov James D, Harker Pablo, Gupta Rajiv, Bernstock Joshua D, Koch Matthew J, Raymond Scott B, Mascitelli Justin R, Patterson T Tyler, Seinfeld Joshua, White Andrew, Case David, Roark Christopher, Gandhi Chirag D, Al-Mufti Fawaz, Cooper Jared, Matouk Charles, Sujijantarat Nanthiya, Devia Diego A, Ocampo-Navia Maria I, Villamizar-Torres Daniel E, Puentes Juan C, Salem Mohamed M, Baig Ammad, El Namaani Kareem, Kühn Anna Luisa, Pukenas Bryan, Jankowitz Brian T, Burkhardt Jan Karl, Siddiqui Adnan, Jabbour Pascal, Singh Jasmeet, Puri Ajit S, Regenhardt Robert W, Mendes Pereira Vitor, Patel Aman B
Аннотация
METHODS: Patients with unruptured intracranial aneurysms requiring PED flow diversion were identified from 13 centers for retrospective evaluation. Clinical variables including the results of PFT before treatment, periprocedural DAPT regimen, and intracranial complications occurring within 72 h of embolization were identified. Complication rates were compared between PFT and non-PFT groups. Differences between groups were tested for statistical significance using the Wilcoxon rank sum, Fisher exact, or χ 2 tests. A P -value <.05 was statistically significant.
RESULTS: 580 patients underwent PED embolization with 262 patients dichotomized to the PFT group and 318 patients to the non-PFT group. 13.7% of PFT group patients were clopidogrel nonresponders requiring changes in their pre-embolization DAPT regimen. Five percentage of PFT group [2.8%, 8.5%] patients experienced thromboembolic complications vs 1.6% of patients in the non-PFT group [0.6%, 3.8%] ( P = .019). Two (15.4%) PFT group patients with thromboembolic complications experienced permanent neurological disability vs 4 (80%) non-PFT group patients. 3.7% of PFT group patients [1.5%, 8.2%] and 3.5% [1.8%, 6.3%] of non-PFT group patients experienced hemorrhagic intracranial complications ( P > .9).
CONCLUSION: Preprocedural PFT before PED treatment of intracranial aneurysms in patients premedicated with an aspirin and clopidogrel DAPT regimen may not be necessary to significantly reduce the risk of procedure-related intracranial complications.