ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2021
Cangrelor dose titration using platelet function testing during cerebrovascular stent placement.
Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Comparative Efficacy and Safety of Intravenous Cangrelor versus Intravenous Glycoprotein IIb/IIIa Inhibitors after Mechanical Thrombectomy for Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.AJNR. American journal of neuroradiology · 2025Pooled it
- Safety and Efficacy of Cangrelor in Acute Stroke Treated with Mechanical Thrombectomy: Endovascular Treatment of Ischemic Stroke Registry and Meta-analysis.AJNR. American journal of neuroradiology · 2022Pooled it
- Intravenous cangrelor infusion for the treatment of traumatic intracranial internal carotid artery dissection: illustrative case.Journal of neurosurgery. Case lessons · 2025Article
- Full dose of cangrelor in the acute treatment of small ruptured cerebral aneurysms with flow diverters: a single center experience.Acta neurochirurgica · 2025Article
- Antiplatelet Therapy and Platelet Activity Testing for Neurointerventional Procedures.Stroke (Hoboken, N.J.) · 2025Review
- Safety of Intravenous Cangrelor Versus Dual Oral Antiplatelet Loading Therapy in Endovascular Treatment of Tandem Lesions: An Observational Cohort Study.Stroke (Hoboken, N.J.) · 2023Article
- Artificial Intelligence and Neurosurgery: Tracking Antiplatelet Response Patterns for Endovascular Intervention.Medicina (Kaunas, Lithuania) · 2023Review
- Rescue of immediate post-transcarotid artery revascularization carotid stent thrombosis due to clopidogrel resistance using flow-reversal and aspiration thrombectomy.Journal of vascular surgery cases and innovative techniques · 2023Article
- Intravenous cangrelor use for neuroendovascular procedures: a two-center experience and updated systematic review.Frontiers in neurology · 2023Article
- P2Y12 inhibitors for the neurointerventionalist.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Review
- Cangrelor Dosing and Monitoring for Prevention of Acute Systemic-to-Pulmonary Artery Shunt Thrombosis in Neonates.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Use of intravenous cangrelor and stenting in acute ischemic stroke interventions: a new single center analysis and pooled-analysis of current studies.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2021Article
- Role of platelets in the pathogenesis of delayed injury after subarachnoid hemorrhage.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Review
- Antiplatelet Drugs for Neurointerventions: Part 2 Clinical Applications.Clinical neuroradiology · 2021Review
- With regard to "The use of cangrelor in neurovascular interventions: a multicenter experience".Neuroradiology · 2021Article
- Safety of Low Dose Intravenous Cangrelor in Acute Ischemic Stroke: A Case Series.Frontiers in neurology · 2021Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOptimal antiplatelet inhibition is vital during cerebrovascular stenting procedures, yet no standardized recommendation exists for antithrombotic therapy in these scenarios. Cangrelor is an intravenous P2Y12 inhibitor with a favorable pharmacokinetic profile for use during neuroendovascular stenting.
methodsA retrospective review of all neuroendovascular patients who underwent stenting between 1 January 2019 and 22 March 2020 and were treated with cangrelor was conducted. Thirty-seven patients met inclusion criteria.
resultsAll patients were administered a bolus of 5 mcg/kg of cangrelor followed by a maintenance infusion. Antiplatelet effects of cangrelor were monitored using platelet reactivity units (PRU). Based on the initial PRU, seven patients' doses were adjusted with subsequent PRUs in or near the goal range of 50-150. One patient experienced an acute intraprocedural occlusion likely related to a subtherapeutic PRU which subsequently resolved with cangrelor dose adjustment and intra-arterial tirofiban administration, and one patient experienced a post-procedure stent occlusion which required a thrombectomy and intra-arterial tirofiban administration. No hemorrhagic complications occurred. DISCUSSION: Cangrelor utilization during neuroendovascular stenting with maintenance doses of <2 mcg/kg/min with dose adjustments based on platelet function testing has not been previously described. Cangrelor presents many advantages compared to standard therapy in patients undergoing stent placement related to its pharmacokinetic profile, rapid onset of action, ease of transition to oral P2Y
conclusionCangrelor is a promising alternative to currently available therapies, especially in patients with a high hemorrhagic risk.
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Registered trials
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.