Current Perioperative Management of Anticoagulant and Antiplatelet Use in Neuroendovascular Therapy: Analysis of JR-NET1 and 2
To evaluate current perioperative antithrombotic management in neuroendovascular therapy in Japan, we analyzed perioperative anticoagulant and antiplatelet use in various procedures and examined their relationships with periprocedural adverse events. Patient’s data from nationwide surveys administer...
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Veröffentlicht in: | Neurologia medico-chirurgica 2014, Vol.54(1), pp.9-16 |
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description | To evaluate current perioperative antithrombotic management in neuroendovascular therapy in Japan, we analyzed perioperative anticoagulant and antiplatelet use in various procedures and examined their relationships with periprocedural adverse events. Patient’s data from nationwide surveys administered by the Japanese Registry of Neuroendovascular Therapy (JR-NET) between January 2005 and December 2007 (JR-NET1) and January 2008 and December 2009 (JR-NET2) were retrospectively analyzed. Compared to JR-NET1, the frequency of perioperative antiplatelet therapy and dual or triple therapy were increased for either aneurysm coiling and percutaneous transluminal angioplasty or stenting in JR-NET2. Although ischemic complications were significantly decreased (4.2% vs. 2.1%, p < 0.001), hemorrhagic complications (2.1% vs. 5.3%, p < 0.001), severe adverse events (1.5% vs. 2.1%, p < 0.001), and total perioperative complications (8.3% vs. 10.3%, p < 0.001) were significantly increased in JR-NET2. The rate of hemorrhagic complications was significantly higher in patients with triple or more perioperative antiplatelet therapy (preoperative: 5.3% vs. 9.2%, p < 0.0001, postoperative: 5.7% vs. 12.7%, p < 0.0001). Perioperative antithrombotic therapy was performed more frequently and intensively in neuroendovascular therapy in Japan. While ischemic complications were decreased, hemorrhagic complications and severe adverse events were increased. These results suggest that intensive antithrombotic therapy has a potential risk of hemorrhagic complications for Japanese patients. |
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Patient’s data from nationwide surveys administered by the Japanese Registry of Neuroendovascular Therapy (JR-NET) between January 2005 and December 2007 (JR-NET1) and January 2008 and December 2009 (JR-NET2) were retrospectively analyzed. Compared to JR-NET1, the frequency of perioperative antiplatelet therapy and dual or triple therapy were increased for either aneurysm coiling and percutaneous transluminal angioplasty or stenting in JR-NET2. Although ischemic complications were significantly decreased (4.2% vs. 2.1%, p < 0.001), hemorrhagic complications (2.1% vs. 5.3%, p < 0.001), severe adverse events (1.5% vs. 2.1%, p < 0.001), and total perioperative complications (8.3% vs. 10.3%, p < 0.001) were significantly increased in JR-NET2. The rate of hemorrhagic complications was significantly higher in patients with triple or more perioperative antiplatelet therapy (preoperative: 5.3% vs. 9.2%, p < 0.0001, postoperative: 5.7% vs. 12.7%, p < 0.0001). Perioperative antithrombotic therapy was performed more frequently and intensively in neuroendovascular therapy in Japan. While ischemic complications were decreased, hemorrhagic complications and severe adverse events were increased. These results suggest that intensive antithrombotic therapy has a potential risk of hemorrhagic complications for Japanese patients.]]></description><identifier>ISSN: 0470-8105</identifier><identifier>EISSN: 1349-8029</identifier><identifier>DOI: 10.2176/nmc.oa2013-0160</identifier><identifier>PMID: 24305029</identifier><language>eng</language><publisher>Japan: The Japan Neurosurgical Society</publisher><subject><![CDATA[Angioplasty - statistics & numerical data ; anticoagulant ; Anticoagulants - adverse effects ; Anticoagulants - therapeutic use ; antiplatelet ; Aortic Dissection - therapy ; Drug Therapy, Combination ; Drug Utilization ; Embolization, Therapeutic - instrumentation ; Embolization, Therapeutic - statistics & numerical data ; Endovascular Procedures - statistics & numerical data ; Health Care Surveys - statistics & numerical data ; Hemorrhage - chemically induced ; Hemorrhage - epidemiology ; Humans ; Intracranial Aneurysm - therapy ; neuroendovascular therapy ; Neurosurgical Procedures - statistics & numerical data ; Perioperative Care - methods ; Perioperative Care - statistics & numerical data ; Platelet Aggregation Inhibitors - adverse effects ; Platelet Aggregation Inhibitors - therapeutic use ; Postoperative Complications - prevention & control ; Premedication ; Registries ; Retrospective Studies ; Stents ; Thromboembolism - prevention & control]]></subject><ispartof>Neurologia medico-chirurgica, 2014, Vol.54(1), pp.9-16</ispartof><rights>2014 by The Japan Neurosurgical Society</rights><rights>2014 The Japan Neurosurgical Society 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c752t-938ff8811db431ce3fbab730dfae2f17a4fb544c88a077bd289f396c91648c363</citedby><cites>FETCH-LOGICAL-c752t-938ff8811db431ce3fbab730dfae2f17a4fb544c88a077bd289f396c91648c363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508699/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508699/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,1883,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24305029$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ENOMOTO, Yukiko</creatorcontrib><creatorcontrib>YOSHIMURA, Shinichi</creatorcontrib><creatorcontrib>SAKAI, Nobuyuki</creatorcontrib><creatorcontrib>EGASHIRA, Yusuke</creatorcontrib><creatorcontrib>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</creatorcontrib><creatorcontrib>Department of Neurosurgery</creatorcontrib><creatorcontrib>Graduate School of Medicine</creatorcontrib><creatorcontrib>Japanese Registry of Neuroendovascular Therapy (JR-NET Investigators</creatorcontrib><creatorcontrib>Kobe City Medical Center General Hospital</creatorcontrib><creatorcontrib>Gifu University</creatorcontrib><creatorcontrib>Japanese Registry of Neuroendovascular Therapy Investigators</creatorcontrib><creatorcontrib>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</creatorcontrib><title>Current Perioperative Management of Anticoagulant and Antiplatelet Use in Neuroendovascular Therapy: Analysis of JR-NET1 and 2</title><title>Neurologia medico-chirurgica</title><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><description><![CDATA[To evaluate current perioperative antithrombotic management in neuroendovascular therapy in Japan, we analyzed perioperative anticoagulant and antiplatelet use in various procedures and examined their relationships with periprocedural adverse events. Patient’s data from nationwide surveys administered by the Japanese Registry of Neuroendovascular Therapy (JR-NET) between January 2005 and December 2007 (JR-NET1) and January 2008 and December 2009 (JR-NET2) were retrospectively analyzed. Compared to JR-NET1, the frequency of perioperative antiplatelet therapy and dual or triple therapy were increased for either aneurysm coiling and percutaneous transluminal angioplasty or stenting in JR-NET2. Although ischemic complications were significantly decreased (4.2% vs. 2.1%, p < 0.001), hemorrhagic complications (2.1% vs. 5.3%, p < 0.001), severe adverse events (1.5% vs. 2.1%, p < 0.001), and total perioperative complications (8.3% vs. 10.3%, p < 0.001) were significantly increased in JR-NET2. The rate of hemorrhagic complications was significantly higher in patients with triple or more perioperative antiplatelet therapy (preoperative: 5.3% vs. 9.2%, p < 0.0001, postoperative: 5.7% vs. 12.7%, p < 0.0001). Perioperative antithrombotic therapy was performed more frequently and intensively in neuroendovascular therapy in Japan. While ischemic complications were decreased, hemorrhagic complications and severe adverse events were increased. These results suggest that intensive antithrombotic therapy has a potential risk of hemorrhagic complications for Japanese patients.]]></description><subject>Angioplasty - statistics & numerical data</subject><subject>anticoagulant</subject><subject>Anticoagulants - adverse effects</subject><subject>Anticoagulants - therapeutic use</subject><subject>antiplatelet</subject><subject>Aortic Dissection - therapy</subject><subject>Drug Therapy, Combination</subject><subject>Drug Utilization</subject><subject>Embolization, Therapeutic - instrumentation</subject><subject>Embolization, Therapeutic - statistics & numerical data</subject><subject>Endovascular Procedures - statistics & numerical data</subject><subject>Health Care Surveys - statistics & numerical data</subject><subject>Hemorrhage - chemically induced</subject><subject>Hemorrhage - epidemiology</subject><subject>Humans</subject><subject>Intracranial Aneurysm - therapy</subject><subject>neuroendovascular therapy</subject><subject>Neurosurgical Procedures - statistics & numerical data</subject><subject>Perioperative Care - methods</subject><subject>Perioperative Care - statistics & numerical data</subject><subject>Platelet Aggregation Inhibitors - adverse effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Postoperative Complications - prevention & control</subject><subject>Premedication</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Stents</subject><subject>Thromboembolism - prevention & control</subject><issn>0470-8105</issn><issn>1349-8029</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkU1v2zAMho1hwxp0Pe82-LiLW-rDtrzDgKJIuw1dNwzpWZBlOlHhSJlkB8hlv31M0gXdQRRAvnpI8c2y9wwuOaurK7-2l8FwYKIAVsGrbMaEbAoFvHmdzUDWUCgG5Vl2kZJrAbhUUqj6bXbGpYCSZLPsz80UI_ox_4nRhQ1GM7ot5t-NN0tc7wuhz6_96Gwwy2kwlDC-O2Q2gxlxwDF_TJg7nz_gFAP6LmxNsiSN-WJFvM3uE8nNsEsu7WHffhUP8wU7YPi77E1vhoQXz_d59ng7X9x8Ke5_3H29ub4vbF3ysWiE6nulGOtaKZhF0bemrQV0vUHes9rIvi2ltEoZqOu246rpRVPZhlVSWVGJ8-zzkbuZ2jV2lj4WzaA30a1N3OlgnP6_4t1KL8NWyxJU1TQE-PgMiOH3hGnUa5csDrQRDFPSrBRScShFSdKro9TGkFLE_tSGgd4bp8k4fTRO742jFx9eTnfS_7OJBHdHAVWdNUPwg_Oon8IUabNJ24552j5qYkoNUEpgdHE60FBgFeeskaCIND-SntJIDp9amUgWD3gYrZSa7cOLEU91uzJRoxd_AStAxc4</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>ENOMOTO, Yukiko</creator><creator>YOSHIMURA, Shinichi</creator><creator>SAKAI, Nobuyuki</creator><creator>EGASHIRA, Yusuke</creator><creator>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</creator><general>The Japan Neurosurgical Society</general><general>THE JAPAN NEUROSURGICAL SOCIETY</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>5PM</scope></search><sort><creationdate>20140101</creationdate><title>Current Perioperative Management of Anticoagulant and Antiplatelet Use in Neuroendovascular Therapy: Analysis of JR-NET1 and 2</title><author>ENOMOTO, Yukiko ; YOSHIMURA, Shinichi ; SAKAI, Nobuyuki ; EGASHIRA, Yusuke ; the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c752t-938ff8811db431ce3fbab730dfae2f17a4fb544c88a077bd289f396c91648c363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Angioplasty - statistics & numerical data</topic><topic>anticoagulant</topic><topic>Anticoagulants - adverse effects</topic><topic>Anticoagulants - therapeutic use</topic><topic>antiplatelet</topic><topic>Aortic Dissection - therapy</topic><topic>Drug Therapy, Combination</topic><topic>Drug Utilization</topic><topic>Embolization, Therapeutic - instrumentation</topic><topic>Embolization, Therapeutic - statistics & numerical data</topic><topic>Endovascular Procedures - statistics & numerical data</topic><topic>Health Care Surveys - statistics & numerical data</topic><topic>Hemorrhage - chemically induced</topic><topic>Hemorrhage - epidemiology</topic><topic>Humans</topic><topic>Intracranial Aneurysm - therapy</topic><topic>neuroendovascular therapy</topic><topic>Neurosurgical Procedures - statistics & numerical data</topic><topic>Perioperative Care - methods</topic><topic>Perioperative Care - statistics & numerical data</topic><topic>Platelet Aggregation Inhibitors - adverse effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Postoperative Complications - prevention & control</topic><topic>Premedication</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Stents</topic><topic>Thromboembolism - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ENOMOTO, Yukiko</creatorcontrib><creatorcontrib>YOSHIMURA, Shinichi</creatorcontrib><creatorcontrib>SAKAI, Nobuyuki</creatorcontrib><creatorcontrib>EGASHIRA, Yusuke</creatorcontrib><creatorcontrib>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</creatorcontrib><creatorcontrib>Department of Neurosurgery</creatorcontrib><creatorcontrib>Graduate School of Medicine</creatorcontrib><creatorcontrib>Japanese Registry of Neuroendovascular Therapy (JR-NET Investigators</creatorcontrib><creatorcontrib>Kobe City Medical Center General Hospital</creatorcontrib><creatorcontrib>Gifu University</creatorcontrib><creatorcontrib>Japanese Registry of Neuroendovascular Therapy Investigators</creatorcontrib><creatorcontrib>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurologia medico-chirurgica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ENOMOTO, Yukiko</au><au>YOSHIMURA, Shinichi</au><au>SAKAI, Nobuyuki</au><au>EGASHIRA, Yusuke</au><au>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</au><aucorp>Department of Neurosurgery</aucorp><aucorp>Graduate School of Medicine</aucorp><aucorp>Japanese Registry of Neuroendovascular Therapy (JR-NET Investigators</aucorp><aucorp>Kobe City Medical Center General Hospital</aucorp><aucorp>Gifu University</aucorp><aucorp>Japanese Registry of Neuroendovascular Therapy Investigators</aucorp><aucorp>the Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Current Perioperative Management of Anticoagulant and Antiplatelet Use in Neuroendovascular Therapy: Analysis of JR-NET1 and 2</atitle><jtitle>Neurologia medico-chirurgica</jtitle><addtitle>Neurol. Med. Chir.(Tokyo)</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>54</volume><issue>1</issue><spage>9</spage><epage>16</epage><pages>9-16</pages><issn>0470-8105</issn><eissn>1349-8029</eissn><abstract><![CDATA[To evaluate current perioperative antithrombotic management in neuroendovascular therapy in Japan, we analyzed perioperative anticoagulant and antiplatelet use in various procedures and examined their relationships with periprocedural adverse events. Patient’s data from nationwide surveys administered by the Japanese Registry of Neuroendovascular Therapy (JR-NET) between January 2005 and December 2007 (JR-NET1) and January 2008 and December 2009 (JR-NET2) were retrospectively analyzed. Compared to JR-NET1, the frequency of perioperative antiplatelet therapy and dual or triple therapy were increased for either aneurysm coiling and percutaneous transluminal angioplasty or stenting in JR-NET2. Although ischemic complications were significantly decreased (4.2% vs. 2.1%, p < 0.001), hemorrhagic complications (2.1% vs. 5.3%, p < 0.001), severe adverse events (1.5% vs. 2.1%, p < 0.001), and total perioperative complications (8.3% vs. 10.3%, p < 0.001) were significantly increased in JR-NET2. The rate of hemorrhagic complications was significantly higher in patients with triple or more perioperative antiplatelet therapy (preoperative: 5.3% vs. 9.2%, p < 0.0001, postoperative: 5.7% vs. 12.7%, p < 0.0001). Perioperative antithrombotic therapy was performed more frequently and intensively in neuroendovascular therapy in Japan. While ischemic complications were decreased, hemorrhagic complications and severe adverse events were increased. These results suggest that intensive antithrombotic therapy has a potential risk of hemorrhagic complications for Japanese patients.]]></abstract><cop>Japan</cop><pub>The Japan Neurosurgical Society</pub><pmid>24305029</pmid><doi>10.2176/nmc.oa2013-0160</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese; EZB-FREE-00999 freely available EZB journals; PubMed Central |
subjects | Angioplasty - statistics & numerical data anticoagulant Anticoagulants - adverse effects Anticoagulants - therapeutic use antiplatelet Aortic Dissection - therapy Drug Therapy, Combination Drug Utilization Embolization, Therapeutic - instrumentation Embolization, Therapeutic - statistics & numerical data Endovascular Procedures - statistics & numerical data Health Care Surveys - statistics & numerical data Hemorrhage - chemically induced Hemorrhage - epidemiology Humans Intracranial Aneurysm - therapy neuroendovascular therapy Neurosurgical Procedures - statistics & numerical data Perioperative Care - methods Perioperative Care - statistics & numerical data Platelet Aggregation Inhibitors - adverse effects Platelet Aggregation Inhibitors - therapeutic use Postoperative Complications - prevention & control Premedication Registries Retrospective Studies Stents Thromboembolism - prevention & control |
title | Current Perioperative Management of Anticoagulant and Antiplatelet Use in Neuroendovascular Therapy: Analysis of JR-NET1 and 2 |
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