Evidence map›Paper›PMID 35549746›Full record

ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2023

Dual antiplatelet use in the management of COVID-19 associated acute ischemic stroke reocclusion.

Joshua Feler, Carlin Chuck, Matthew Anderson, Jonathan Poggi, Joseph Sweeney, Krisztina Moldovan, Mahesh V Jayaraman, Ryan McTaggart, Radmehr Torabi

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

Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 35% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Review
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

9 authors at 1 institution in 1 country.

Joshua FelerDepartment of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Carlin ChuckDepartment of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA.ORCID 0000-0001-5735-2654
Matthew AndersonDepartment of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Jonathan PoggiDepartment of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Joseph SweeneyDepartment of Hematology-Oncology, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Krisztina MoldovanDepartment of Interventional Radiology, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Mahesh V JayaramanDepartment of Interventional Radiology, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Ryan McTaggartDepartment of Interventional Radiology, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Radmehr TorabiDepartment of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA.
Brown University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introSARS-CoV-2 (COVID-19) infection is associated with acute ischemic stroke (AIS), which may be due to a prothrombotic state. Early reports have suggested high rates of reocclusion following mechanical thrombectomy (MT) with poor radiographic and clinical outcomes. We report our early experience using intra-procedural antithrombotics to address SARS-CoV-2 reocclusion.

methodsWe identified 6 patients that experienced early reocclusion after MT for COVID-19-associated AIS through retrospective chart review abstracting their basic demographics, COVID-19 status, and stroke management. All these patients were treated after reocclusion with aspirin and cangrelor intra-procedurally, the latter of which was converted to ticagrelor post-procedurally. Some patients additionally received argatroban infusion intraprocedurally.

resultsMean age was 54. There were 3 post-procedural and 3 intra-procedural re-occlusions. After repeat thrombectomy and treatment with aspirin and cangrelor, those with post-procedure reocclusion did not show further reocclusion, while those with intra-procedural reocclusion showed radiographic improvement with intraprocedural cangrelor administration. Outcomes for these patients were poor, with a median mRS of 4. Two patients developed petechial hemorrhage of their stroke which was managed conservatively, and one developed a retroperitoneal hemorrhage from femoral access requiring transfusion. There were no patients who developed new parenchymal hematomas.

conclusionCOVID-19 AIS may be associated with a hypercoagulable state which risks malignant reocclusion complicating MT. We found antithrombotic treatment periprocedural cangrelor with or without argatroban transitioned to oral aspirin with ticagrelor to be a viable method for management of these patients.

Indexed as

Brain IschemiaCOVID-19Ischemic StrokeStrokeArginineAspirinHumansMiddle AgedPipecolic AcidsRetrospective StudiesSARS-CoV-2SulfonamidesThrombectomyTicagrelorTreatment OutcomeargatrobanArginineAspirinPipecolic AcidsSulfonamidesTicagrelorantithroboticscOVID-19strokethrombectomy

Identifiers

PMID35549746
PMCPMC10549714
OpenAlexW4280524303

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.