Evidence map›Paper›PMID 30626980›Full record

ArticleThe Canadian journal of hospital pharmacy

Ticagrelor and Acetylsalicylic Acid after Placement of Pipeline Embolization Device for Cerebral Aneurysm: A Case Series.

Jodi R DeGrote, Elizabeth M Olafson, Alexander Drofa, Evgueni Kouznetzov, Michael Manchak, Nathan D Leedahl, David D Leedahl

Open access · bronzeAbstract read
PubMed Full text at PMC
In one paragraph

Article in The Canadian journal of hospital pharmacy. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Article
  5. The Value of Case Reports.The Canadian journal of hospital pharmacy
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  6. The Canadian journal of hospital pharmacy
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Jodi R DeGrote, PharmD, BCCCP, is with Pharmacy Services, Sanford Medical Center, Fargo, North Dakota.
Elizabeth M Olafson, PharmD, is with Pharmacy Services, Sanford Medical Center, Fargo, North Dakota.
Alexander Drofa, MD, is with the Department of Surgery, University of North Dakota, Grand Forks, North Dakota, and the Department of Neurosurgery, Sanford Brain and Spine Institute, Fargo, North Dakota.
Evgueni Kouznetzov, MD, is with the Department of Neurosurgery, Sanford Brain and Spine Institute, Fargo, North Dakota.
Michael Manchak, MD, is with the Department of Neurosurgery, Sanford Brain and Spine Institute, Fargo, North Dakota.
Nathan D Leedahl, PharmD, BCPS, is with Pharmacy Services, Sanford Medical Center, Fargo, North Dakota.
David D Leedahl, PharmD, BCPS-AQ ID, BCCCP, is with Pharmacy Services, Sanford Medical Center, Fargo, North Dakota.
University of North Dakota · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDual antiplatelet therapy with acetylsalicylic acid (ASA) and a P2Y12-receptor antagonist is often used to prevent thrombotic complications after placement of a Pipeline embolization device (PED) for cerebral aneurysm. Although clopidogrel is common in this setting, high rates of nonresponse to this drug have made ticagrelor a potentially attractive alternative.

objectiveTo describe safety and efficacy outcomes for ticagrelor following PED placement, including measurement of platelet function.

methodsA retrospective analysis of data was completed for patients who underwent PED placement for cerebral aneurysm at a single centre between November 2015 and March 2017, with subsequent prescription of ticagrelor and ASA as dual antiplatelet therapy. The primary end point was any ischemic stroke or death within 1 year after the procedure. Intracranial hemorrhage was a secondary end point. Additionally, measurement of and values for platelet reactivity units (PRUs) during receipt of ticagrelor and ASA were evaluated.

resultsA total of 29 patients were included in this retrospective study. One patient experienced ischemic stroke 226 days after placement of the PED. In addition, 3 patients died during the 1-year follow-up period for causes unrelated to stroke or bleeding complications. No cases of intracranial hemorrhage were observed. Samples for measurement of P2Y12 levels were drawn at the discretion of the neurointerventionalists, and the PRU value was measured at least once for 28 (97%) of the 29 patients. The mean number of PRU measurements per patient after initiation of ticagrelor was 2.1 (standard deviation [SD] 1). Mean PRU value after initiation of ticagrelor was 65 (SD 57).

conclusionsIn this case series describing the use of ticagrelor and ASA as dual antiplatelet therapy after PED placement for cerebral aneurysm, there was just one ischemic stroke, which occurred after the dual antiplatelet therapy had been discontinued. Further prospective trials are needed to describe the utility of ticagrelor use after PED placement, as well as its dosing and monitoring.

Indexed as

antiplatelet agentdual antiplatelet therapyflow diversionneurointerventionPipeline embolization deviceticagrelor

Identifiers

PMID30626980
PMCPMC6306182
OpenAlexW2906907797

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.