Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome
Abstract Background Endovascular therapy (EVT) for large intracranial vessel occlusion or symptomatic hypoperfusion due to cervical artery dissection (CeAD) became the standard therapy in recent years. Stenting is frequently required to secure the dissection with subsequent need for GP IIb/IIIa inhi...
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| Format: | Article |
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SpringerOpen
2025-05-01
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| Series: | CVIR Endovascular |
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| Online Access: | https://doi.org/10.1186/s42155-025-00564-9 |
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| author | Abira Sornalingam Susanne Wegener Miranda Stattmann Jil Baumann Patrick Thurner Jawid Madjidyar Hakim Shakir Husain Miklos Krepuska Christoph Globas Andreas R. Luft Zsolt Kulcsar Tilman Schubert |
| author_facet | Abira Sornalingam Susanne Wegener Miranda Stattmann Jil Baumann Patrick Thurner Jawid Madjidyar Hakim Shakir Husain Miklos Krepuska Christoph Globas Andreas R. Luft Zsolt Kulcsar Tilman Schubert |
| author_sort | Abira Sornalingam |
| collection | DOAJ |
| description | Abstract Background Endovascular therapy (EVT) for large intracranial vessel occlusion or symptomatic hypoperfusion due to cervical artery dissection (CeAD) became the standard therapy in recent years. Stenting is frequently required to secure the dissection with subsequent need for GP IIb/IIIa inhibitors. However, a potential concern of antithrombotic therapy in acute stroke is the increased risk of intracerebral hemorrhage. The aim of the study was to assess the impact of the administration of a GP IIb/IIIa inhibitor imaging during endovascular treatment for acute ischemic stroke caused by CeAD on 90-day clinical outcome and intracranial hemorrhage. Methods This single-center retrospective cohort study enrolled CeAD patients with internal carotid artery (ICA) dissections treated with EVT from January 2015 to August 2022. We analysed the impact of different variables including postinterventional hemorrhage, revascularization success and the use of GP IIb/IIIa Inhibitors (eptifibatide) on 90-day favorable clinical outcome (mRS 0–2). NIHSS Scores were evaluated at different time points in relation to the 90-day clinical outcomes. Results Forty-nine patients were included in the study. Thrombectomy was performed in all patients. In 33 patients, stenting was performed in addition to thrombectomy. 20 patients (40.8%) received eptifibatide periinterventionally. 31 out of 49 patients (63.3%) had a favorable 90-day clinical outcome (mRS 0–2). Five patients showed radiologically significant hemorrhage. The rate of successful reperfusion (TICI 2b-3) in the favorable 90-day outcome group was significantly higher than in the unfavorable 90-day outcome group. Conclusions In this study, the use of a GP IIb/IIIa inhibitor use during EVT for stroke caused by CeAD did not affect 90-day clinical outcome nor the incidence of intracranial hemorrhage. Successful reperfusion significantly correlated with favorable clinical outcome. |
| format | Article |
| id | doaj-art-d6cd458ea3b54dcfac2a829ff75d9a74 |
| institution | DOAJ |
| issn | 2520-8934 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | SpringerOpen |
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| series | CVIR Endovascular |
| spelling | doaj-art-d6cd458ea3b54dcfac2a829ff75d9a742025-08-20T03:08:43ZengSpringerOpenCVIR Endovascular2520-89342025-05-018111010.1186/s42155-025-00564-9Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcomeAbira Sornalingam0Susanne Wegener1Miranda Stattmann2Jil Baumann3Patrick Thurner4Jawid Madjidyar5Hakim Shakir Husain6Miklos Krepuska7Christoph Globas8Andreas R. Luft9Zsolt Kulcsar10Tilman Schubert11Department of Neuroradiology, University Hospital ZurichDepartment of Neurology, University Hospital ZurichDepartment of Neurology, University Hospital ZurichDepartment of Neurology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neurology, University Hospital ZurichDepartment of Neurology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichDepartment of Neuroradiology, University Hospital ZurichAbstract Background Endovascular therapy (EVT) for large intracranial vessel occlusion or symptomatic hypoperfusion due to cervical artery dissection (CeAD) became the standard therapy in recent years. Stenting is frequently required to secure the dissection with subsequent need for GP IIb/IIIa inhibitors. However, a potential concern of antithrombotic therapy in acute stroke is the increased risk of intracerebral hemorrhage. The aim of the study was to assess the impact of the administration of a GP IIb/IIIa inhibitor imaging during endovascular treatment for acute ischemic stroke caused by CeAD on 90-day clinical outcome and intracranial hemorrhage. Methods This single-center retrospective cohort study enrolled CeAD patients with internal carotid artery (ICA) dissections treated with EVT from January 2015 to August 2022. We analysed the impact of different variables including postinterventional hemorrhage, revascularization success and the use of GP IIb/IIIa Inhibitors (eptifibatide) on 90-day favorable clinical outcome (mRS 0–2). NIHSS Scores were evaluated at different time points in relation to the 90-day clinical outcomes. Results Forty-nine patients were included in the study. Thrombectomy was performed in all patients. In 33 patients, stenting was performed in addition to thrombectomy. 20 patients (40.8%) received eptifibatide periinterventionally. 31 out of 49 patients (63.3%) had a favorable 90-day clinical outcome (mRS 0–2). Five patients showed radiologically significant hemorrhage. The rate of successful reperfusion (TICI 2b-3) in the favorable 90-day outcome group was significantly higher than in the unfavorable 90-day outcome group. Conclusions In this study, the use of a GP IIb/IIIa inhibitor use during EVT for stroke caused by CeAD did not affect 90-day clinical outcome nor the incidence of intracranial hemorrhage. Successful reperfusion significantly correlated with favorable clinical outcome.https://doi.org/10.1186/s42155-025-00564-9Cervical artery dissectionIschemic strokeEndovascular thrombectomyGP IIb/IIIa inhibitor |
| spellingShingle | Abira Sornalingam Susanne Wegener Miranda Stattmann Jil Baumann Patrick Thurner Jawid Madjidyar Hakim Shakir Husain Miklos Krepuska Christoph Globas Andreas R. Luft Zsolt Kulcsar Tilman Schubert Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome CVIR Endovascular Cervical artery dissection Ischemic stroke Endovascular thrombectomy GP IIb/IIIa inhibitor |
| title | Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome |
| title_full | Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome |
| title_fullStr | Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome |
| title_full_unstemmed | Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome |
| title_short | Emergency endovascular treatment of stroke due to cervical artery dissection – impact of periprocedural GP IIb/IIIa inhibitor use on clinical outcome |
| title_sort | emergency endovascular treatment of stroke due to cervical artery dissection impact of periprocedural gp iib iiia inhibitor use on clinical outcome |
| topic | Cervical artery dissection Ischemic stroke Endovascular thrombectomy GP IIb/IIIa inhibitor |
| url | https://doi.org/10.1186/s42155-025-00564-9 |
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