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

Jildaz Caroff 1 Laurent Aubert 2 Cécile Lavenu-Bombled 2 Samy Figueiredo 2 Kamelia Habchi 2 Jonathan Cortese 1 Francois Eugene 3 Julien Ognard 4, 5 Florence Tahon 6 Géraud Forestier 7 Heloise Ifergan 8 François Zhu 9, 10 Jean-Francois Hak 11 Anthony Reyre 11 Morgane Laubacher 10 Abdoulaye Traore 12 Jean Philippe Desilles 13 Imad Derraz 14 Ricardo Moreno 15 Marc Bintner 16 Guillaume Charbonnier 17 Anthony Le Bras 18 Louis Veunac 19 Florent Gariel 20 Hocine Redjem 21 Jacques Sedat 22 Guillaume Tessier 23 Victor Dumas 24 Maxime Gauberti 25 Cyril Chivot 26 Arturo Consoli 27 Nicolas Bricout 28 Titien Tuilier 29 Alexis Guedon 30 Raoul Pop 31 Pierre Thouant 32 Guillaume Bellanger 33 Riccardo Zannoni 34 Sebastien Soize 35 Johann Sebastian Richter 36 Olivier Heck 37 Cristian Mihalea 1 Julien Burel 38 Jean-Baptiste Girot 39 Eimad Shotar 40 Sebastian Gazzola 41 Gregoire Boulouis 42 Basile Kerleroux 43 
Abstract : 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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https://hal-univ-fcomte.archives-ouvertes.fr/hal-03654643
Contributor : Guillaume Charbonnier Connect in order to contact the contributor
Submitted on : Thursday, April 28, 2022 - 5:12:00 PM
Last modification on : Friday, September 9, 2022 - 10:20:08 AM

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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, BMJ Journals, 2022, pp.neurintsurg-2021-018601. ⟨10.1136/neurintsurg-2021-018601⟩. ⟨hal-03654643⟩

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