The Experts below are selected from a list of 111 Experts worldwide ranked by ideXlab platform
Keunhwa Jung - One of the best experts on this subject based on the ideXlab platform.
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intra arterial tirofiban infusion for Thromboembolic Complication during coil embolization of ruptured intracranial aneurysms
European Journal of Radiology, 2012Co-Authors: Hyunseung Kang, Keunhwa JungAbstract:Abstract Introduction Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for Thromboembolic Complications during coil embolization in patients with ruptured intracranial aneurysms. Methods Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site ( n = 13), followed by the middle cerebral artery ( n = 9) and the posterior communicating artery ( n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms.
Yuichi Murayama - One of the best experts on this subject based on the ideXlab platform.
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e 054 strict antiplatelet management using platelet aggregation test may reduce Thromboembolic Complication in patients with stent assisted coil embolization
Journal of NeuroInterventional Surgery, 2018Co-Authors: Toshihiro Ishibashi, Ichiro Yuki, Kenichi Sakuta, Tomonobu Kodama, S Kaku, Naoki Kato, Kengo Nishimura, Ken Aoki, Yuichi MurayamaAbstract:Purpose Antiplatelet management is essential in neuroendovascular treatment, especially with intracranial stent deployment, for Thromboembolic Complication reduction. There are few articles which described the use of light transmission aggregometry (LTA) as a platelet function test prior to deployment of intracranial stent. The aim of this study was to evaluate the usefulness of strict antiplatelet management in patients with stent assisted coil embolization. Method A total of 372 patients with intracranial aneurysms were treated with endovascular procedure from July 2015 to March 2018. During the period, 119 patients underwent stent-assisted coil embolization. All patients were measured platelet function test before procedure. Platelet function test was performed using LTA measuring adenosine diphosphate (ADP). We retrospectively analyzed Thromboembolic Complication based on two protocols (stages) of antiplatelet management for that period. In early stage, the patients were taken regular double antiplatelet therapy (aspirin 100 mg and clopidogrel 75 mg, daily) seven days before the procedure. In the late stage, we employed strict antiplatelet management described as follows: if ADP value is less than 60, additional clopidogrel 75 mg was administered in addition to the regular double antiplatelet therapy. Thromboembolic Complications occurring from the date of the procedure until discharge were evaluated. Results In the early stage (July 2015 to August 2016), three Thromboembolic Complications were occurred out of 35 patients (8.6%). Patients with Complications had significantly higher average ADP value than those without Complication (60.7 versus 45.6; p=0.018). A cut-off value of ADP was 62 (AUC 0.807, Sensitivity 0.67, Specificity 0.93). In the late stage (August 2016 to March 2018), CLP boosting was conducted in nine patients out of 84 patients (10.7%). The rate of Thromboembolic Complication was significantly lower in late stage than that in the early stage (1.2% versus 8.6%; p=0.04). Conclusion Strict antiplatelet management using platelet aggregation test may reduce Thromboembolic Complication in patients with stent assisted coil embolization. Disclosures I. Kan: None. T. Ishibashi: None. I. Yuki: None. K. Sakuta: None. T. Kodama: None. S. Kaku: None. N. Kato: None. K. Nishimura: None. K. Aoki: None. Y. Murayama: None.
Hyunseung Kang - One of the best experts on this subject based on the ideXlab platform.
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intra arterial tirofiban infusion for Thromboembolic Complication during coil embolization of ruptured intracranial aneurysms
European Journal of Radiology, 2012Co-Authors: Hyunseung Kang, Keunhwa JungAbstract:Abstract Introduction Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for Thromboembolic Complications during coil embolization in patients with ruptured intracranial aneurysms. Methods Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site ( n = 13), followed by the middle cerebral artery ( n = 9) and the posterior communicating artery ( n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms.
Toshihiro Ishibashi - One of the best experts on this subject based on the ideXlab platform.
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e 054 strict antiplatelet management using platelet aggregation test may reduce Thromboembolic Complication in patients with stent assisted coil embolization
Journal of NeuroInterventional Surgery, 2018Co-Authors: Toshihiro Ishibashi, Ichiro Yuki, Kenichi Sakuta, Tomonobu Kodama, S Kaku, Naoki Kato, Kengo Nishimura, Ken Aoki, Yuichi MurayamaAbstract:Purpose Antiplatelet management is essential in neuroendovascular treatment, especially with intracranial stent deployment, for Thromboembolic Complication reduction. There are few articles which described the use of light transmission aggregometry (LTA) as a platelet function test prior to deployment of intracranial stent. The aim of this study was to evaluate the usefulness of strict antiplatelet management in patients with stent assisted coil embolization. Method A total of 372 patients with intracranial aneurysms were treated with endovascular procedure from July 2015 to March 2018. During the period, 119 patients underwent stent-assisted coil embolization. All patients were measured platelet function test before procedure. Platelet function test was performed using LTA measuring adenosine diphosphate (ADP). We retrospectively analyzed Thromboembolic Complication based on two protocols (stages) of antiplatelet management for that period. In early stage, the patients were taken regular double antiplatelet therapy (aspirin 100 mg and clopidogrel 75 mg, daily) seven days before the procedure. In the late stage, we employed strict antiplatelet management described as follows: if ADP value is less than 60, additional clopidogrel 75 mg was administered in addition to the regular double antiplatelet therapy. Thromboembolic Complications occurring from the date of the procedure until discharge were evaluated. Results In the early stage (July 2015 to August 2016), three Thromboembolic Complications were occurred out of 35 patients (8.6%). Patients with Complications had significantly higher average ADP value than those without Complication (60.7 versus 45.6; p=0.018). A cut-off value of ADP was 62 (AUC 0.807, Sensitivity 0.67, Specificity 0.93). In the late stage (August 2016 to March 2018), CLP boosting was conducted in nine patients out of 84 patients (10.7%). The rate of Thromboembolic Complication was significantly lower in late stage than that in the early stage (1.2% versus 8.6%; p=0.04). Conclusion Strict antiplatelet management using platelet aggregation test may reduce Thromboembolic Complication in patients with stent assisted coil embolization. Disclosures I. Kan: None. T. Ishibashi: None. I. Yuki: None. K. Sakuta: None. T. Kodama: None. S. Kaku: None. N. Kato: None. K. Nishimura: None. K. Aoki: None. Y. Murayama: None.
Makhan S Khangure - One of the best experts on this subject based on the ideXlab platform.
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use of glycoprotein iib iiia inhibitor for a Thromboembolic Complication during guglielmi detachable coil treatment of an acutely ruptured aneurysm
American Journal of Neuroradiology, 2001Co-Authors: Perry P Ng, Constantine C Phatouros, Makhan S KhangureAbstract:Summary: Thrombotic occlusion of the anterior communicating and right anterior cerebral arteries occurred during embolization of an acutely ruptured aneurysm of the anterior communicating artery. Traditional management, including superselective infusion of a fibrinolytic agent, was unsuccessful in reestablishing normal vessel patency. Therefore, an intravenous dose of abciximab was administered. Serial angiography showed that normal vessel patency was reestablished within 10 min. There were no adverse events related to abciximab administration, and the patient recovered from the procedure without neurologic deficit.