Evidence map›Paper›PMID 32974691›Full record

ArticleNeuroradiology2021

A DELPHI consensus statement on antiplatelet management for intracranial stenting due to underlying atherosclerosis in the setting of mechanical thrombectomy.

Mayank Goyal, Kirill Orlov, Mary E Jensen, Allan Taylor, Charles Majoie, Mahesh Jayaraman, Jianmin Liu, Geneviève Milot, Patrick Brouwer, Shinichi Yoshimura and 12 more

Erratum issuedAbstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
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

9 citing papers in PubMed.

  1. Multicenter comparison of antiplatelet treatment strategies for urgent/emergent neuroendovascular stenting.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    Article
  2. Article
  3. Article
  4. Article
  5. Glycoprotein IIb/IIIa inhibitors for the neurointerventionalist.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022
    Review
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  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Mayank GoyalDepartments of Radiology and Clinical Neurosciences, Foothills Medical Centre, University of Calgary, 1403 29th St. NW, Calgary, AB, T2N2T9, Canada. mgoyal@ucalgary.ca.ORCID http://orcid.org/0000-0001-9060-2109
Kirill OrlovMeshalkin National Medical Research Center, Novosibirsk, Russian Federation.
Mary E JensenDepartments of Neurological Surgery, Radiology and Medical Imaging, UVA Health, Charlottesville, VA, USA.
Allan TaylorGroote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Charles MajoieDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, location AMC, Amsterdam, The Netherlands.
Mahesh JayaramanDepartments of Diagnostic Imaging, Neurology and Neurosurgery Warren Alpert School of Medicine at Brown University, Providence, RI, USA.
Jianmin LiuDepartment of Neurosurgery, Changhai Hospital Naval Medical University, Shanghai, China.
Geneviève MilotDepartment of Neurosurgery, CHU de Québec, Quebec City, Canada.
Patrick BrouwerDepartment of Interventional Neuroradiology, Karolinksa Hospital, Stockholm, Sweden.
Shinichi YoshimuraDepartment of Neurosurgery, Hyogo College of Medicine 1-1 Mukogawa, Nishinomiya, Hyogo, Japan.
Felipe AlbuquerqueDepartment of Neurosurgery, Barrow Neurological Institute, Phoenix, USA.
Adam ArthurDepartment of Neurosurgery, Semmes-Murphey Clinic/ University of TN, Memphis, TN, USA.
David KallmesDepartment of Radiology, Mayo Clinic, Rochester, USA.
Nobuyuki SakaiDepartment of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan.
Justin F FraserDepartments of Neurosurgery, Neurology, Radiology, and Neuroscience, University of Kentucky, Lexington, KY, USA.
Raul NogueiraMarcus Stroke & Neuroscience Center, Grady Memorial Hospital and Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Pengfei YangDepartment of Neurosurgery, Changhai Hospital Naval Medical University, Shanghai, China.
Franziska DornDepartment of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Lucie ThibaultWFITN, Paris, France.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
René ChapotDepartment of Neuroradiology, Alfred Krupp Krankenhaus Essen, Essen, Germany.
Johanna Maria OspelDepartment of Clinical Neurosciences, University of Calgary, Calgary, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is little data and lack of consensus regarding antiplatelet management for intracranial stenting due to underlying intracranial atherosclerosis in the setting of endovascular treatment (EVT). In this DELPHI study, we aimed to assess whether consensus on antiplatelet management in this situation among experienced experts can be achieved, and what this consensus would be.

methodsWe used a modified DELPHI approach to address unanswered questions in antiplatelet management for intracranial stenting due to underlying atherosclerosis in the setting of EVT. An expert-panel (19 neurointerventionalists from 8 countries) answered structured, anonymized on-line questionnaires with iterative feedback-loops. Panel-consensus was defined as agreement ≥ 70% for binary closed-ended questions/≥ 50% for closed-ended questions with > 2 response options.

resultsPanel members answered a total of 5 survey rounds. They acknowledged that there is insufficient data for evidence-based recommendations in many aspects of antiplatelet management for intracranial stenting due to underlying atherosclerosis in the setting of EVT. They believed that antiplatelet management should follow a standardized regimen, irrespective of imaging findings and reperfusion quality. There was no consensus on the timing of antiplatelet-therapy initiation. Aspirin was the preferred antiplatelet agent for the peri-procedural period, and oral Aspirin in combination with a P2Y12 inhibitor was the favored postprocedural regimen.

conclusionData on antiplatelet management for intracranial stenting due to underlying atherosclerosis in the setting of EVT are limited. Panel-members in this study achieved consensus on postprocedural antiplatelet management but did not agree upon a preprocedural and intraprocedural antiplatelet regimen. Further prospective studies to optimize antiplatelet regimens are needed.

Indexed as

AtherosclerosisStentsDelphi TechniqueHumansProspective StudiesThrombectomyAngiographyIntracranial atherosclerosisIntracranial stentingIschemic stroke

Identifiers

PMID32974691

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.