Title:Efficacy of Cangrelor as Bridging Therapy Post PCI
Volume: 20
Issue: 3
Author(s): Abdul A. Khan, Ghulam Murtaza*, Muhammad Khalid, Mathew Finniss and Thomas Helton
Affiliation:
- Division of Cardiovascular Medicine, East Tennessee State University, TN,United States
Keywords:
Bleeding, gastrointestinal, surgery, antiplatelet, coronary syndrome, hypertension.
Abstract:
Background: Dual antiplatelet therapy (DAPT) remains the cornerstone management for
the prevention of acute stent thrombosis after percutaneous intervention (PCI). Situations
mandating early interruption of DAPT carry a high risk of ischemic complications. Perioperative
bridge therapy using Cangrelor, an intravenous P2Y2 inhibitor, may offer a potential solution.
Unfortunately, evidence for its use in non-cardiac procedures is limited.
Methods: Our protocol demonstrates successful off-label use of IV Cangrelor bridge therapy in a
non-cardiac surgery patient. We describe a case of a 77-year old male; triple therapy with Aspirin,
Apixaban, and Ticagrelor for recent drug-eluting stent placement required immediate surgical
resection of stage I colonic adenocarcinoma.
Results: Cangrelor bridge therapy was utilized both preoperatively and postoperatively without
ischemic or bleeding complications. The patient tolerated exploratory laparoscopic colectomy with
minimal bleeding and good post-op recovery.
Conclusion: Minimizing the interruption of DAPT therapy in high-risk patients is achievable.
However, careful planning with a team-based approach involving surgeons, cardiologists and
pharmacists, along with close clinical follow-up and vigilant management of anti-platelet therapy is
recommended.
