PMID- 24391160
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20220321
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Linking)
VI  - 6
IP  - 10
DP  - 2014 Dec
TI  - Heterogeneous practice patterns regarding antiplatelet medications for 
      neuroendovascular stenting in the USA: a multicenter survey.
PG  - 774-9
LID - 10.1136/neurintsurg-2013-010954 [doi]
AB  - BACKGROUND: Adequate dual antiplatelet (AP) therapy is imperative when performing 
      neurovascular stenting procedures. Currently, no consensus for the ideal AP 
      regimen exists. Thus the present study aimed to gain a better understanding of 
      real world practice AP patterns by surveying neurointerventional surgeons. 
      METHODS: Survey links were emailed to 296 neurointerventional surgeons practicing 
      in the USA, asking 51 questions including demographics, stent specific use, AP 
      pre and post-medication, types of APs, point of care (POC) assessment, 
      complications, and outcomes. Data were collected and analyzed using Research 
      Electronic Data Capture (REDCap). RESULTS: 74 participants responded; 56.8% were 
      from academic centers. Participants treated an average of 5.5 aneurysms per 
      month. They placed an average of 1.6 intracranial stents and 1.4 cervical stents 
      per month. Mean number of pipeline embolization devices (PEDs) placed per year 
      was 15.2. Heterogeneity existed regarding AP regimens; the most frequent included 
      acetylsalicylic acid (ASA) 325 mg+Plavix 75 mg daily (for 7 days prior) and ASA 
      325 mg+Plavix 75 mg daily (for 5 days prior) for routine placement of 
      intracranial and cervical stents, respectively. For emergency placement, ASA 
      325 mg+Plavix 600 mg (at time of surgery) was the most frequently used. 46.8% 
      routinely used POC testing, most frequently VerifyNow (Accumetrics, San Diego, 
      California, USA); the most common threshold determining a non-responder was <30% 
      inhibition. 85.7% used POC for PED placement. Management changes based on POC 
      testing were diverse. CONCLUSIONS: The results highlight the heterogeneity of 
      current practices regarding AP medication regimens during neurovascular stenting. 
      Given its importance, evidence based protocols are imperative. Minimal literature 
      exists focusing on neurovasculature, and therefore understanding current practice 
      patterns represents a first step toward generating these protocols.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Faught, Ryan W F
AU  - Faught RW
AD  - Department of Neurosurgery, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania, USA.
FAU - Satti, Sudhakar R
AU  - Satti SR
AD  - Department of Neurointerventional Surgery, Christiana Care Health System, 
      Wilmington, Delaware, USA.
FAU - Hurst, Robert W
AU  - Hurst RW
AD  - Department of Radiology, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania, USA.
FAU - Pukenas, Bryan A
AU  - Pukenas BA
AD  - Department of Radiology, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania, USA.
FAU - Smith, Michelle Janine
AU  - Smith MJ
AD  - Department of Neurosurgery, Hospital of the University of Pennsylvania, 
      Philadelphia, Pennsylvania, USA.
LA  - eng
PT  - Journal Article
DEP - 20140103
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Blood Vessel Prosthesis/statistics & numerical data
MH  - Blood Vessel Prosthesis Implantation/*methods/statistics & numerical data
MH  - Cerebrovascular Disorders/drug therapy/*surgery
MH  - Data Collection
MH  - Humans
MH  - Intracranial Thrombosis/prevention & control
MH  - Neurosurgery/*statistics & numerical data
MH  - Platelet Aggregation Inhibitors/*therapeutic use
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Stents/*statistics & numerical data
MH  - United States
OTO - NOTNLM
OT  - Drug
OT  - Flow Diverter
OT  - Platelets
OT  - Standards
OT  - Stent
EDAT- 2014/01/07 06:00
MHDA- 2015/07/21 06:00
CRDT- 2014/01/07 06:00
PHST- 2014/01/07 06:00 [entrez]
PHST- 2014/01/07 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
AID - neurintsurg-2013-010954 [pii]
AID - 10.1136/neurintsurg-2013-010954 [doi]
PST - ppublish
SO  - J Neurointerv Surg. 2014 Dec;6(10):774-9. doi: 10.1136/neurintsurg-2013-010954. 
      Epub 2014 Jan 3.