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The Use of Cangrelor as Bridge Antiplatelet Therapy in a Patient with Recent Percutaneous Coronary Intervention for Acute Coronary Syndrome, Who Developed Esophageal Perforation After Transesophageal Echocardiography.
Turk Kardiyol Dern Ars
July 2024
Department of Cardiology, Kocaeli University Medical Faculty, Kocaeli, Türkiye.
Article Synopsis
- Dual antiplatelet therapy (DAPT) is crucial for managing patients with coronary artery disease during procedures like percutaneous coronary intervention (PCI), but can pose risks if surgery is needed urgently.
- Cangrelor, an intravenous medication, allows rapid and potent platelet inhibition, which can be quickly reversed, making it a potential solution for patients needing to temporarily stop DAPT.
- In a case of a patient with recent PCI who developed an esophageal perforation, prolonged cangrelor use effectively helped manage the situation without causing any thrombotic or bleeding complications.
Feasibility and Safety of Bridging Antiplatelet Therapy with Cangrelor in Neuro-Oncology: A Preliminary Experience.
J Neurol Surg A Cent Eur Neurosurg
January 2025
Neurosurgery Unit, Head and Neck Department, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Article Synopsis
- Antiplatelet therapy is crucial for preventing blood clots in patients with recent heart issues, but urgent surgeries pose challenges in balancing bleeding and clotting risks.
- Current literature lacks a consensus on the best approach to manage antiplatelet therapy during surgery, particularly for neurosurgical cases, although some guidelines exist for other types.
- In a reported case, a patient undergoing brain tumor surgery safely used an intravenous P2Y inhibitor (cangrelor) as a bridging therapy, showing no bleeding or heart-related problems during and after the procedure.
Navigating P2Y12 inhibition in the labyrinth of cardio-oncology care: cangrelor bridging in patients with cancer.
Front Cardiovasc Med
February 2024
Department of Cardiology, MD Anderson Cancer Center, Houston, TX, United States.
Cangrelor, a potent intravenous P2Y12 platelet inhibitor, has demonstrated effectiveness in reducing ischemic events without a corresponding increase in severe bleeding during percutaneous coronary intervention, as evidenced by the CHAMPION-PHOENIX trial. Its off-label role as a bridging antiplatelet agent for patients facing high thrombotic risks who must temporarily stop oral P2Y12 inhibitor therapy further underscores its clinical utility. This is the first case series to shed light on the application of cangrelor in cancer patients needing to pause dual antiplatelet therapy for a range of medical interventions, marking it as a pioneering effort in this domain.
View Article and Find Full Text PDFUrgent Revascularization of the Left Proximal Circumflex Following Cessation of Cangrelor Within Six Hours of Procedure.
Cureus
June 2023
Cardiology and Lifestyle Medicine, James A. Haley Veterans Affair Medical Center, Tampa, USA.
Patients undergoing procedures are often transitioned off anticoagulants using anti-platelet agents with short half-lives as a "bridge." We present the case of a patient with a history of in-stent thromboses who experienced a thrombotic event following a literature-guided bridging protocol. This case is one of the first to show that stopping cangrelor within six hours led to a need for urgent revascularization and suggests that the timing for discontinuing bridging agents should be customized based on the patient's history of increased blood clotting.
View Article and Find Full Text PDFAnti-thrombotic Therapy With Cangrelor and Bivalirudin in Venoarterial Extracorporeal Membrane Oxygenation Patients Undergoing Percutaneous Coronary Intervention: A Single-Center Experience.
ASAIO J
July 2023
Cardiac Surgery Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
VA-ECMO is commonly used for patients in cardiogenic shock (CS) or refractory cardiac arrest (CA) undergoing PCI for ACS. In this setting at high risk of both thrombotic and hemorrhagic complications, optimal anti-thrombotic therapy remains ill-defined. We hypothesized that an anti-thrombotic therapy comprising a parenteral anticoagulant (bivalirudin) and a parenteral anti-platelet agent (cangrelor) may prove safe and effective in this scenario.
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