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Use of Antiplatelet Agents in the Neurosurgical Patient
This article presents the relevant data supporting the use of antiplatelet agents in vascular neurosurgery and recommendations based on the described studies.
Source: Neurosurgery Clinics of North America - September 15, 2018 Category: Neurosurgery Authors: Amanda S. Zakeri, Shahid M. Nimjee Source Type: research

P2Y12 hyporesponse (PRU>200) is not associated with increased thromboembolic complications in anterior circulation Pipeline
Conclusions P2Y12 hyporesponse (PRU>200) is not associated with increased periprocedural complications in a contemporary series of patients undergoing anterior circulation PED placement. Titration of antiplatelet medications to P2Y12 >200 remains unindicated and may increase the risk of hemorrhagic complications.
Source: Journal of NeuroInterventional Surgery - September 12, 2017 Category: Neurosurgery Authors: Bender, M. T., Lin, L.-M., Colby, G. P., Lubelski, D., Huang, J., Tamargo, R. J., Coon, A. L. Tags: Clinical neurology Source Type: research

E-022 Low dose eptifibatide for acute icad intervention results in high incidence of acute reocclusion
Conclusion The low dose eptifibatide protocol employed here was safe in that no hemorrhages occurred. However, three of six target vessels re-occluded acutely. While the data are limited, the protocol appears to lack adequate potency to prevent re-occlusion of acutely treated ICAD lesions. Disclosures C. Roels: None. M. Brown: None. R. Janjua: None. D. Heck: 2; C; Stryker.
Source: Journal of NeuroInterventional Surgery - July 23, 2017 Category: Neurosurgery Authors: Roels, C., Brown, M., Janjua, R., Heck, D. Tags: Electronic Poster Abstracts Source Type: research

Emergent carotid stenting and intra-arterial abciximab in acute ischemic stroke due to tandem occlusion
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Source: British Journal of Neurosurgery - March 16, 2017 Category: Neurosurgery Authors: Fawaz Al-Mufti Krishna Amuluru Nathan W. Manning Imad Khan Lissa Peeling Chirag D. Gandhi Charles J. Prestigiacomo Galyna Pushchinska David Fiorella Henry H. Woo Source Type: research

Intra-arterial versus intravenous abciximab therapy for thromboembolic complications of neuroendovascular procedures: case review and meta-analysis
Conclusions Abciximab produces a high rate of angiographic improvement and a low incidence of postprocedural infarct in neuroendovascular procedures complicated by thromboemboli. IA abciximab produces greater angiographic improvement than IV treatment. Postprocedural infarction is less common in patients with complete angiographic response than in those with partial or no response.
Source: Journal of NeuroInterventional Surgery - January 12, 2017 Category: Neurosurgery Authors: Kansagra, A. P., McEachern, J. D., Madaelil, T. P., Wallace, A. N., Cross, D. T., Moran, C. J., Derdeyn, C. P. Tags: Ischemic stroke Source Type: research

Successful Endovascular Management of Massive Pansinus Thrombosis: Case Report and Review of Literature
We present the case of a 9-day-old infant, who presented in coma and was treated successfully with a combination of mechanical thrombectomy using the MindFrame System via the right jugular vein, local infusion of recombinant tissue plasminogen activator and abciximab, as well as anticoagulation. In this case, aggressive thrombectomy and thrombolysis achieved complete neurologic restoration safely and quickly.Pediatr Neurosurg
Source: Pediatric Neurosurgery - August 31, 2016 Category: Neurosurgery Source Type: research

Intraprocedural abciximab bolus versus pretreatment oral dual antiplatelet medication for endovascular stenting of unruptured intracranial aneurysms
Conclusions Standalone intraprocedural abciximab bolus was not associated with an increased rate of complications compared with pretreatment with DAPM for unruptured intracranial aneurysm stenting.
Source: Journal of NeuroInterventional Surgery - August 11, 2016 Category: Neurosurgery Authors: Levitt, M. R., Moon, K., Albuquerque, F. C., Mulholland, C. B., Kalani, M. Y. S., McDougall, C. G. Tags: Hemorrhagic stroke Source Type: research

E-065 "Rescue" Intracranial Stenting for Refractory Large Vessel (Re)occlusion in Acute Ischemic Stroke
ConclusionIntracranial stent placement for refractory large vessel (re)occlusion in acute ischemic stroke is feasible with high technical success rate, however, this is not always associated with favorable clinical outcome. If refractory vessel occlusion or reocclusion is encountered during acute stroke intervention, early stent placement and recanalization may lead to more favorable outcome. Verification in a larger cohort is necessary.DisclosuresG. Toth: None. S. John: None. M. Elgabaly: None. M. Hussain: None. M. Bain: None.
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Toth, G., John, S., Elgabaly, M., Hussain, M., Bain, M. Tags: Electronic poster abstracts Source Type: research

P-001 Permanent Implantation of the Solitaire Device as a Bailout Technique for Large Vessel Intracranial Occlusions
ConclusionWith the recent over-whelming evidence demonstrating the effectiveness endovascular therapy in acute ischemic stroke, the expansion of stroke therapy requires that a variety of techniques be available to the operators. Permanent implantation of the Solitaire stent achieves adequate distal flow and good clinical outcomes in the setting of AIS. This case series suggests this technique provides a safe alternative for difficult cases refractory to other revascularization techniques.Key Wordsstroke, revascularization, stentDisclosuresJ. Houde: None. E. Barber: None. M. Kelly: 2; C; Medtronic. 4; C; Blockade. 6; C; Pen...
Source: Journal of NeuroInterventional Surgery - July 28, 2016 Category: Neurosurgery Authors: Houde, J., Barber, E., Kelly, M., Peeling, L. Tags: Oral poster abstracts Source Type: research

Carotid stenting and intracranial thrombectomy for treatment of acute stroke due to tandem occlusions with aggressive antiplatelet therapy may be associated with a high incidence of intracranial hemorrhage
Conclusions Primary stenting of the extracranial carotid artery combined with intracranial mechanical thrombectomy can be an effective treatment for tandem occlusions, can be performed with a high rate of technical success, and can achieve good clinical outcomes in selected patients. However, the incidence of SICH may be higher than in other patient populations and may be associated with the use of abciximab and advanced patient age.
Source: Journal of NeuroInterventional Surgery - February 12, 2015 Category: Neurosurgery Authors: Heck, D. V., Brown, M. D. Tags: Ischemic stroke Source Type: research

E-056 Pipeline Endovascular Device for the Treatment of Intracranial Aneurysm at the Level of the Circle of Willis and Beyond: Multicenter Experience
Conclusion The PED provides a safe and effective solution for aneurysms at and beyond the circle of Willis. Preliminary results are promising but larger series with longer-term follow-up examinations are required to show the long-term safety and durability of this treatment alternative. Disclosures M. Martínez-Galdámez: 2; C; Covidien. I. Linfante: 2; C; Covidien, Stryker, Codman. E. Lin: None. G. Dabus: 2; C; Covidien, Microvention, Reverse Medical.
Source: Journal of NeuroInterventional Surgery - July 26, 2014 Category: Neurosurgery Authors: Martinez-Galdamez, M., Linfante, I., Lin, E., Dabus, G. Tags: Electronic poster abstracts Source Type: research