A DELPHI consensus statement on antiplatelet management for intracranial stenting due to underlying atherosclerosis in t
- PDF / 340,435 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 14 Downloads / 181 Views
INTERVENTIONAL NEURORADIOLOGY
A DELPHI consensus statement on antiplatelet management for intracranial stenting due to underlying atherosclerosis in the setting of mechanical thrombectomy Mayank Goyal 1 & Kirill Orlov 2 & Mary E. Jensen 3 & Allan Taylor 4 & Charles Majoie 5 & Mahesh Jayaraman 6 & Jianmin Liu 7 & Geneviève Milot 8 & Patrick Brouwer 9,10 & Shinichi Yoshimura 11 & Felipe Albuquerque 12 & Adam Arthur 13 & David Kallmes 14 & Nobuyuki Sakai 15 & Justin F. Fraser 16 & Raul Nogueira 17 & Pengfei Yang 7 & Franziska Dorn 18 & Lucie Thibault 19 & Jens Fiehler 20 & René Chapot 21 & Johanna Maria Ospel 22,23 Received: 23 June 2020 / Accepted: 10 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose There 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. Methods We 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. Results Panel 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. Conclusion Data 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. Keywords Ischemic stroke . Intracranial atherosclerosis . Angiography . Intracranial stenting
Introduction There are no large prospective studies on the effect of different antiplatelet regimens on clinical outcomes and complications
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00234-020-02556-z) contains supplementary material, which is available to authorized users. * May
Data Loading...
