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Article Dans Une Revue Journal of Neurointerventional Surgery Année : 2022

Antithrombotic therapies for neurointerventional surgery: a 2021 French comprehensive national survey

1 Service de Neuroradiologie [CHU de Bicêtre]
2 AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre)
3 Service de Neuroradiologie [Rennes]
4 CHU - Brest - HM - CHRU Brest - Service d'Imagerie médicale
5 Optimisation Continue des Actions Thérapeutiques par l'Intégration d'Informations Multimodales
6 Hôpital Privé Clairval [Marseille]
7 CHU Limoges
8 Service de neuroradiologie [Tours]
9 Département de neuroradiologie diagnostique et thérapeutique [CHRU Nancy]
10 HCL - Hospices Civils de Lyon
11 TIMONE - Hôpital de la Timone [CHU - APHM]
12 Service de Neurologie [Hôpitaux Civils de Colmar]
13 Fondation Ophtalmologique Adolphe de Rothschild [Paris]
14 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
15 CHU Clermont-Ferrand
16 CHU La Réunion - Centre Hospitalier Universitaire de La Réunion
17 Service de Neuroradiologie Interventionnelle [CHU Besançon]
18 CHBA - Centre hospitalier Bretagne Atlantique (Morbihan)
19 CHCB - Centre Hospitalier de la Côte Basque
20 CHU de Bordeaux Pellegrin [Bordeaux]
21 Clinique des Cèdres
22 CHU Nice - Centre Hospitalier Universitaire de Nice
23 Département de Neuroradiologie [CHU Nantes]
24 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
25 CHU Caen
26 CHU Amiens-Picardie
27 Service Neuroradiologie diagnostique et interventionnelle [Hôpital Foch]
28 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
29 CHU Henri Mondor [Créteil]
30 Hôpital Lariboisière-Fernand-Widal [APHP]
31 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
32 CHU Dijon
33 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
34 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
35 Hôpital universitaire Robert Debré [Reims]
36 Centre hospitalier de Pau
37 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
38 CHU Rouen
39 CHU Angers - Centre Hospitalier Universitaire d'Angers
40 CHU Pitié-Salpêtrière [AP-HP]
41 Saint Anne Military Teaching Hospital [Toulon, France]
42 CHU Trousseau [Tours]
43 GHU Paris - Centre Hospitalier Saint-Anne
Francois Eugene
Géraud Forestier
Jean-Francois Hak
Florent Gariel
Hocine Redjem
Jacques Sedat
Maxime Gauberti
  • Fonction : Auteur
Cyril Chivot
Pierre Thouant
Julien Burel
Eimad Shotar
Gregoire Boulouis
Basile Kerleroux

Résumé

Background Neurointerventionists lack guidelines for the use of antithrombotic therapies in their clinical practice; consequently, there is likely to be significant heterogeneity in antithrombotic use between centers. Through a nationwide survey, we aimed to obtain an exhaustive cross-sectional overview of antithrombotic use in neurointerventional procedures in France. Methods In April 2021, French neurointerventional surgery centers were invited to participate in a nationwide 51-question survey disseminated through an active trainee-led research collaborative network (the JENI-RC). Results All 40 centers answered the survey. Fifty-one percent of centers reported using ticagrelor and 43% used clopidogrel as premedication before intracranial stenting. For flow diversion treatment, dual antiplatelet therapy was maintained for 3 or 6 months in 39% and 53% of centers, respectively, and aspirin was prescribed for 12 months or more than 12 months in 63% and 26% of centers, respectively. For unruptured aneurysms, the most common heparin bolus dose was 50 IU/kg (59%), and only 35% of centers monitored heparin activity for dose adjustment. Tirofiban was used in 64% of centers to treat thromboembolic complications. Fifteen percent of these comprehensive stroke centers reported using tenecteplase to treat acute ischemic strokes. Cangrelor appeared as an emergent drug in specific indications. Conclusion This nationwide survey highlights the important heterogeneity in clinical practices across centers. There is a pressing need for trials and guidelines to further evaluate and harmonize antithrombotic regimens in the neurointerventional field.
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Dates et versions

hal-03654643 , version 1 (28-04-2022)

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Citer

Jildaz Caroff, Laurent Aubert, Cécile Lavenu-Bombled, Samy Figueiredo, Kamelia Habchi, et al.. Antithrombotic therapies for neurointerventional surgery: a 2021 French comprehensive national survey. Journal of Neurointerventional Surgery, 2022, pp.neurintsurg-2021-018601. ⟨10.1136/neurintsurg-2021-018601⟩. ⟨hal-03654643⟩
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