PURPOSE Cangrelor is an intravenous P2Y12 receptor inhibitor with a rapid onset/offset of action and a short half-life (3-6 min). The objective was to present a preliminary experience regarding the safety and effectiveness using cangrelor, in combination with aspirin, in acute ischemic stroke patients requiring acute stenting. MATERIAL AND METHODS Retrospective analysis for patients who underwent stenting (intracranial and/or extracranial) in the setting of acute ischemic stroke with cangrelor and aspirin as antiplatelet therapy. RESULTS Cangrelor was used in 12 patients, 4 (33%) with extracranial stenting, 6 (50%) with intracranial stenting and 2 (17%) with combined extracranial and intracranial stenting. The mean age was 67 years (44-88) and 9 patients (75%) were female. The median National Institutes of Health Stroke Score at admission was 15 (IQR: 8-22). Of the patients, six (50%) received intravenous thrombolysis. All patients (100%) obtained modified thrombolysis in cerebral infarction score ≥2b. Good clinical outcome, defined as modified Rankin scale score ≤2 at 3‑months follow-up, was observed in 7 patients (58%). None of the patients experienced intraprocedural thromboembolic complications. Postprocedural stent thrombosis after cessation of cangrelor infusion due to emergency craniotomy surgery to manage malignant cerebral infarction occurred in one patient (8%). Of the patients, two (17%) experienced asymptomatic intracranial hemorrhage (ICH), one patient (8%) experienced symptomatic ICH and one (8%) retroperitoneal hematoma was observed, which was managed conservatively. CONCLUSION Cangrelor might be a safe and effective antiplatelet medication owing to its on/off activity for acute stenting in the setting of acute ischemic stroke. Further investigations through randomized studies with larger samples are necessary.

中文翻译：

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急性缺血性中风中的 Cangrelor 和支架植入：单中心病例系列。

用途 Cangrelor 是一种静脉内 P2Y12 受体抑制剂，起效/消退快，半衰期短（3-6 分钟）。目的是介绍在需要急性支架置入术的急性缺血性卒中患者中使用坎格雷洛联合阿司匹林的安全性和有效性的初步经验。材料和方法 对接受坎格雷洛和阿司匹林作为抗血小板治疗的急性缺血性卒中患者接受支架植入术（颅内和/或颅外）的回顾性分析。结果 12 名患者使用了坎格雷洛，其中 4 名（33%）使用颅外支架，6 名（50%）使用颅内支架，2 名（17%）使用颅外和颅内联合支架。平均年龄为 67 岁 (44-88)，9 名患者 (75%) 为女性。入院时美国国立卫生研究院卒中评分中位数为 15（IQR：8-22）。在这些患者中，6 名（50%）接受了静脉溶栓治疗。所有患者（100%）在脑梗死评分≥2b 中获得改良溶栓。7 名患者 (58%) 观察到良好的临床结果，定义为在 3 个月的随访中改良 Rankin 量表评分≤2。没有患者出现术中血栓栓塞并发症。一名患者 (8%) 因急诊开颅手术治疗恶性脑梗死而停止输注坎格雷洛后发生术后支架内血栓形成。在这些患者中，2 名 (17%) 出现无症状颅内出血 (ICH)，1 名 (8%) 出现症状性 ICH，1 名 (8%) 出现腹膜后血肿，并采取保守治疗。结论 Cangrelor 可能是一种安全有效的抗血小板药物，因为它对急性缺血性卒中的急性支架置入术具有开/关活性。有必要通过更大样本的随机研究进行进一步调查。