Changing paradigms of periprocedural antithrombotic therapy in neuroendovascular therapy: Analysis of JR-NET 3

Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators

Research output: Contribution to journalArticle

Abstract

To evaluate the changing paradigms of periprocedural antithrombotic management in neuroendovascular therapy in Japan, we analyzed the details of the current periprocedural antithrombotic therapy and compared it with those of the previous generations. We retrospectively analyzed the data from the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey in Japan for neuroendovascular therapy between January 2010 and December 2014. A total of 26,233 patients underwent endovascular treatments to usually perform periprocedural antithrombotic therapy were retrospectively analyzed. We compared the results of JR-NET 3 with those of JR-NET 1 (January 2005 and December 2007) and JR-NET 2 (January 2008-December 2009). Post-procedural anticoagulant therapy was less utilized in JR-NET 3 than in JR-NET 2 (53.9% vs. 60.6%, P <0.001). Pre-procedural antiplatelet therapy became more frequent and more intensive with each generation. The frequency of aggressive therapy (dual, and triple or more therapy) was 65.2% in JR-NET 3, which was significantly higher than that of JR-NET 1 and JR-NET 2 (41.5% and 61.2%, respectively, P <0.001). However, periprocedural ischemic complications (2.0% vs. 5.8%, P <0.001) significantly increased, despite aggressive antiplatelet therapy. Neuroendovascular periprocedural antithrombotic therapy is focused more on antiplatelet therapy than on anticoagulant therapy. Currently, antiplatelet therapy is more frequently used with a larger number of multiple agents, however, periprocedural ischemic complications significantly increased.

Original languageEnglish
Pages (from-to)247-256
Number of pages10
JournalNeurologia medico-chirurgica
Volume59
Issue number7
DOIs
Publication statusPublished - Jan 1 2019

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Registries
Therapeutics
Anticoagulants
Japan

Keywords

  • Anticoagulant
  • Antiplatelet
  • Neuroendovascular therapy

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Changing paradigms of periprocedural antithrombotic therapy in neuroendovascular therapy : Analysis of JR-NET 3. / Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators.

In: Neurologia medico-chirurgica, Vol. 59, No. 7, 01.01.2019, p. 247-256.

Research output: Contribution to journalArticle

Japanese Registry of Neuroendovascular Therapy (JR-NET) investigators. / Changing paradigms of periprocedural antithrombotic therapy in neuroendovascular therapy : Analysis of JR-NET 3. In: Neurologia medico-chirurgica. 2019 ; Vol. 59, No. 7. pp. 247-256.
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abstract = "To evaluate the changing paradigms of periprocedural antithrombotic management in neuroendovascular therapy in Japan, we analyzed the details of the current periprocedural antithrombotic therapy and compared it with those of the previous generations. We retrospectively analyzed the data from the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3, a nationwide survey in Japan for neuroendovascular therapy between January 2010 and December 2014. A total of 26,233 patients underwent endovascular treatments to usually perform periprocedural antithrombotic therapy were retrospectively analyzed. We compared the results of JR-NET 3 with those of JR-NET 1 (January 2005 and December 2007) and JR-NET 2 (January 2008-December 2009). Post-procedural anticoagulant therapy was less utilized in JR-NET 3 than in JR-NET 2 (53.9{\%} vs. 60.6{\%}, P <0.001). Pre-procedural antiplatelet therapy became more frequent and more intensive with each generation. The frequency of aggressive therapy (dual, and triple or more therapy) was 65.2{\%} in JR-NET 3, which was significantly higher than that of JR-NET 1 and JR-NET 2 (41.5{\%} and 61.2{\%}, respectively, P <0.001). However, periprocedural ischemic complications (2.0{\%} vs. 5.8{\%}, P <0.001) significantly increased, despite aggressive antiplatelet therapy. Neuroendovascular periprocedural antithrombotic therapy is focused more on antiplatelet therapy than on anticoagulant therapy. Currently, antiplatelet therapy is more frequently used with a larger number of multiple agents, however, periprocedural ischemic complications significantly increased.",
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