PT  - JOURNAL ARTICLE
AU  - J.E. Delgado Almandoz
AU  - B.M. Crandall
AU  - J.M. Scholz
AU  - J.L. Fease
AU  - R.E. Anderson
AU  - Y. Kadkhodayan
AU  - D.E. Tubman
TI  - Last-Recorded P2Y12 Reaction Units Value Is Strongly Associated with Thromboembolic and Hemorrhagic Complications Occurring Up to 6 Months after Treatment in Patients with Cerebral Aneurysms Treated with the Pipeline Embolization Device
AID  - 10.3174/ajnr.A3621
DP  - 2014 Jan 01
TA  - American Journal of Neuroradiology
PG  - 128--135
VI  - 35
IP  - 1
4099  - http://www.ajnr.org/content/35/1/128.short
4100  - http://www.ajnr.org/content/35/1/128.full
SO  - Am. J. Neuroradiol.2014 Jan 01; 35
AB  - BACKGROUND AND PURPOSE: A recent study identified a preprocedural P2Y12 reaction units value of <60 or >240 as a strong independent predictor of perioperative thromboembolic and hemorrhagic complications after treatment of cerebral aneurysms with the Pipeline Embolization Device. This study aimed to determine whether a last-recorded P2Y12 reaction units value of <60 or >240 predicts thromboembolic and hemorrhagic complications up to 6 months after treatment of cerebral aneurysms with the Pipeline Embolization Device in the same patient cohort. MATERIALS AND METHODS: We recorded patient and aneurysm characteristics, P2Y12 receptor antagonist administered, P2Y12 reaction units value with VerifyNow, procedural variables, and thromboembolic and hemorrhagic complications up to 6 months after Pipeline Embolization Device procedures at our institution during an 8-month period. Complications causing a permanent disabling neurologic deficit or death were considered major. Multivariate regression analysis was performed to identify independent predictors of thromboembolic and hemorrhagic complications. RESULTS: Forty-four patients underwent 48 Pipeline Embolization Device procedures at our institution during the study period. There were 11 thromboembolic and hemorrhagic complications up to 6 months after treatment in our cohort (22.9%), 5 of which were major (10.4%). A last-recorded P2Y12 reaction units value of <60 or >240 was the only independent predictor of all (P = .002) and major (P = .03) thromboembolic and hemorrhagic complications in our cohort. Most patients (71%) required, on average, 2 adjustments to the dose or type of P2Y12 receptor antagonist to remain within the 60–240 target P2Y12 reaction units range. CONCLUSIONS: In our cohort, a last-recorded P2Y12 reaction units value of <60 or >240 was the only independent predictor of all and major thromboembolic and hemorrhagic complications up to 6 months after Pipeline Embolization Device procedures. DATdual antiplatelet therapyICHparenchymal intracerebral hemorrhagePEDPipeline Embolization DevicePRUP2Y12 reaction units