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Subcutaneous bruising and aneurysm rebleeding: 2 case reports In a retrospective study of 24 patients with intracranial aneurysm and who were treated with flow diversion (FD) treatment between January 2018 and September 2019, two patients were described, who developed subcutaneous bruising or aneurysm rebleeding during treatment with ticagrelor or tirofiban as antiplatelet therapy. [dosages and outcomes not stated; no all routes and duration of treatments to reactions onsets stated] The patients, who had been diagnosed with an intracranial aneurysm, were scheduled to undergo flow diversion treatment by placing pipeline embolization device (PED) in the blood vessel. Subsequently, the procedure was performed under unspecified general anaesthesia. Both the patients received heparin during flow diversion procedure. During the procedure, one of the patient developed in-stent thrombosis (IST), requiring intra-arterial tirofiban therapy by diluting with sodium-chloride [saline] solution, followed by ticagrelor 90mg twice daily, while other patient received only ticagrelor therapy as single antiplatelet therapy (SAPT) for the prevention of thromboembolic complications. Following the procedure, one patient developed subcutaneous bruising secondary to ticagrelor; while the other patient, who had received tirofiban for IST, developed aneurysm rebleeding on the third day post-procedure. The patient, who had subcutaneous bruising, requiring transition of therapy from ticagrelor to dual antiplatelet therapy (DAPT) with aspirin [acetylsalicylic-acid] and clopidogrel. Mohammaden MH, et al. Safety and efficacy of ticagrelor as single antiplatelet therapy in prevention of thromboembolic complications associated with the Pipeline Embolization Device (PED): Multicenter experience. Journal of NeuroInterventional Surgery 12: 1113-1116, No. 11, Nov 2020. Available from: URL: http://doi.org/10.1136/ 803520422 neurintsurg-2020-015978

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Reactions 12 Dec 2020 No. 1834