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Article Dans Une Revue Journal of Neurointerventional Surgery Année : 2023

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

Géraud Forestier
François Zhu
Guillaume Charbonnier
Anthony Le Bras
Louis Veunac
  • Fonction : Auteur
Florent Gariel
  • Fonction : Auteur
Hocine Redjem
  • Fonction : Auteur
Jacques Sedat
Guillaume Tessier
  • Fonction : Auteur
Victor Dumas
Maxime Gauberti
  • Fonction : Auteur
Cyril Chivot
Arturo Consoli
Nicolas Bricout
Titien Tuilier
  • Fonction : Auteur
Alexis Guedon
  • Fonction : Auteur
Raoul Pop
Pierre Thouant
  • Fonction : Auteur
Guillaume Bellanger
  • Fonction : Auteur
Riccardo Zannoni
  • Fonction : Auteur
Sebastien Soize
  • Fonction : Auteur
Johann Sebastian Richter
  • Fonction : Auteur
Olivier Heck
  • Fonction : Auteur
Cristian Mihalea
Julien Burel
Jean-Baptiste Girot
Eimad Shotar
Sebastian Gazzola
  • Fonction : Auteur
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-04459874 , version 1 (15-02-2024)

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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, 2023, 15 (4), pp.402-407. ⟨10.1136/neurintsurg-2021-018601⟩. ⟨hal-04459874⟩
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