Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®

Introducción. Los eventos tromboembólicos son una de las complicaciones más importantes en los procedimientos neuroendovasculares. La evidencia de la terapia antiplaquetaria dual (DAPT) utilizando el régimen de aspirina y ticagrelor para prevenirlos, es insuficiente en comparación con la DAPT de asp...

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Autores:
Hurtado Ortíz, Kevin Davin
Tipo de recurso:
Fecha de publicación:
2022
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/16047
Acceso en línea:
http://hdl.handle.net/20.500.12749/16047
Palabra clave:
Medical sciences
Health sciences
Vascular diseases
Aneurysm
Endovascular procedures
Salicylic acid
Anti-inflammatory agents
Cardiovascular system
Embolism
Thrombophlebitis
Ciencias médicas
Enfermedades vasculares
Acido salicílico
Agentes antiinflamatorios
Sistema cardiovascular
Embolia
Tromboflebitis
Ciencias de la salud
Aneurisma
Clopidogrel
Ticagrelor
Procedimientos endovasculares
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http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_78339d89449b3c023c1ecd889f64524c
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/16047
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
dc.title.translated.spa.fl_str_mv Comparison of complications of endovascular treatment in patients with unruptured cerebral aneurysms and their relationship with the antiplatelet protocol used, based on the results of VerifyNow®
title Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
spellingShingle Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
Medical sciences
Health sciences
Vascular diseases
Aneurysm
Endovascular procedures
Salicylic acid
Anti-inflammatory agents
Cardiovascular system
Embolism
Thrombophlebitis
Ciencias médicas
Enfermedades vasculares
Acido salicílico
Agentes antiinflamatorios
Sistema cardiovascular
Embolia
Tromboflebitis
Ciencias de la salud
Aneurisma
Clopidogrel
Ticagrelor
Procedimientos endovasculares
title_short Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
title_full Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
title_fullStr Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
title_full_unstemmed Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
title_sort Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®
dc.creator.fl_str_mv Hurtado Ortíz, Kevin Davin
dc.contributor.advisor.none.fl_str_mv Mantilla García, Daniel Eduardo
Serrano Gómez, Sergio
Valenzuela Santos, Carolina
Vera Camargo, Daniela
Ferreira Prada, Carlos
Galvis, Melquisedec
Vargas Pérez, Oliverio
Reyes, Adriana
dc.contributor.author.none.fl_str_mv Hurtado Ortíz, Kevin Davin
dc.contributor.cvlac.spa.fl_str_mv Serrano Gómez, Sergio [0001521095]
Valenzuela Santos, Carolina [0000125123]
Ferreira Prada, Carlos [0001765305]
dc.contributor.googlescholar.spa.fl_str_mv Valenzuela Santos, Carolina [es&oi=ao]
dc.contributor.orcid.spa.fl_str_mv Hurtado Ortíz, Kevin Davin [0000-0001-7841-4498]
Mantilla García, Daniel Eduardo [0000-0002-5727-3195]
Valenzuela Santos, Carolina [0000-0002-2894-5087]
Ferreira Prada, Carlos [0000-0002-7068-356X]
Galvis, Melquisedec [0000-0001-6238-9590]
Vargas Pérez, Oliverio [0000-0003-3389-711X]
dc.contributor.scopus.spa.fl_str_mv Serrano Gómez, Sergio [57197758865]
dc.contributor.researchgate.spa.fl_str_mv Valenzuela Santos, Carolina [Carolina-Valenzuela-Santos-2211127213]
Galvis, Melquisedec [Melquisedec-Galvis-2215881795]
Ferreira Prada, Carlos [Carlos-A-Ferreira-Prada-2211147103]
dc.subject.keywords.spa.fl_str_mv Medical sciences
Health sciences
Vascular diseases
Aneurysm
Endovascular procedures
Salicylic acid
Anti-inflammatory agents
Cardiovascular system
Embolism
Thrombophlebitis
topic Medical sciences
Health sciences
Vascular diseases
Aneurysm
Endovascular procedures
Salicylic acid
Anti-inflammatory agents
Cardiovascular system
Embolism
Thrombophlebitis
Ciencias médicas
Enfermedades vasculares
Acido salicílico
Agentes antiinflamatorios
Sistema cardiovascular
Embolia
Tromboflebitis
Ciencias de la salud
Aneurisma
Clopidogrel
Ticagrelor
Procedimientos endovasculares
dc.subject.lemb.spa.fl_str_mv Ciencias médicas
Enfermedades vasculares
Acido salicílico
Agentes antiinflamatorios
Sistema cardiovascular
Embolia
Tromboflebitis
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Aneurisma
Clopidogrel
Ticagrelor
Procedimientos endovasculares
description Introducción. Los eventos tromboembólicos son una de las complicaciones más importantes en los procedimientos neuroendovasculares. La evidencia de la terapia antiplaquetaria dual (DAPT) utilizando el régimen de aspirina y ticagrelor para prevenirlos, es insuficiente en comparación con la DAPT de aspirina y clopidogrel. Metodología. Se realizó un estudio retrospectivo de cohorte entre el 1 de abril de 2015 y el 30 de diciembre de 2020, en el cual se incluyeron pacientes con aneurismas cerebrales no rotos tratados por vía endovascular con stents diversores y no diversores de flujo, en manejo con aspirina y clopidogrel o con aspirina y ticagrelor como antiagregante. Resultados. En total se incluyeron 148 pacientes con aneurismas intracraneales no rotos con stents diversores y no diversores de flujo. Todos iniciaron DAPT con aspirina más clopidogrel, sin embargo, se suspendió en 24 pacientes por presentar baja respuesta al clopidogrel en el test del VerifyNow y se modificó la terapia a aspirina más ticagrelor. Se presentó una complicación trombótica inmediata en el grupo de clopidogrel (0,81%) y ninguna en el grupo de ticagrelor (0,00%). Así también, una complicación hemorrágica inmediata en el grupo de clopidogrel (0,81%) y ninguna en el grupo de ticagrelor (0,00%). En el seguimiento a 6 meses, 4 pacientes (3,15%) del grupo de clopidogrel, presentaron complicaciones trombóticas y ningún paciente en el grupo de ticagrelor (0,00%). En cuanto a las complicaciones hemorrágicas a 6 meses, se observaron en 4 pacientes (3,23%) del grupo de clopidogrel y en 1 paciente (4,17%) del grupo de ticagrelor. Conclusión. Según nuestro estudio el ticagrelor más aspirina es una alternativa segura y eficaz como DAPT en comparación con el clopidogrel más aspirina, ya que no se presentaron complicaciones tromboembólicas en el grupo de ticagrelor más aspirina.
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-03-24T21:38:51Z
dc.date.available.none.fl_str_mv 2022-03-24T21:38:51Z
dc.date.issued.none.fl_str_mv 2022-02
dc.type.eng.fl_str_mv Thesis
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/16047
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
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url http://hdl.handle.net/20.500.12749/16047
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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institution Universidad Autónoma de Bucaramanga - UNAB
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spelling Mantilla García, Daniel Eduardo02f2cc58-14df-4196-a68a-08dc2290cdc0-1Serrano Gómez, Sergio11c111fa-3f8e-4be2-99fe-62481588d4c5-1Valenzuela Santos, Carolina29b779b2-d5e2-4db1-9d5c-d44c74ee8c2e-1Vera Camargo, Daniela8bb1f134-090d-4690-8513-a9d60473f334-1Ferreira Prada, Carlos4c5e0bc3-cf73-4e70-b055-7e4c5d85f65c-1Galvis, Melquisedec25fe1bf4-9d98-4989-ae23-df9b5e18d04b-1Vargas Pérez, Oliverio8f39c22f-acea-43c2-8555-a9244312d321-1Reyes, Adrianaf5c106f5-5084-45e9-b6cf-828e44a09250-1Hurtado Ortíz, Kevin Davin91148745-1ad7-45ea-9398-b73daca7cc9f-1Serrano Gómez, Sergio [0001521095]Valenzuela Santos, Carolina [0000125123]Ferreira Prada, Carlos [0001765305]Valenzuela Santos, Carolina [es&oi=ao]Hurtado Ortíz, Kevin Davin [0000-0001-7841-4498]Mantilla García, Daniel Eduardo [0000-0002-5727-3195]Valenzuela Santos, Carolina [0000-0002-2894-5087]Ferreira Prada, Carlos [0000-0002-7068-356X]Galvis, Melquisedec [0000-0001-6238-9590]Vargas Pérez, Oliverio [0000-0003-3389-711X]Serrano Gómez, Sergio [57197758865]Valenzuela Santos, Carolina [Carolina-Valenzuela-Santos-2211127213]Galvis, Melquisedec [Melquisedec-Galvis-2215881795]Ferreira Prada, Carlos [Carlos-A-Ferreira-Prada-2211147103]Floridablanca (Santander, Colombia)2015-20202022-03-24T21:38:51Z2022-03-24T21:38:51Z2022-02http://hdl.handle.net/20.500.12749/16047instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coIntroducción. Los eventos tromboembólicos son una de las complicaciones más importantes en los procedimientos neuroendovasculares. La evidencia de la terapia antiplaquetaria dual (DAPT) utilizando el régimen de aspirina y ticagrelor para prevenirlos, es insuficiente en comparación con la DAPT de aspirina y clopidogrel. Metodología. Se realizó un estudio retrospectivo de cohorte entre el 1 de abril de 2015 y el 30 de diciembre de 2020, en el cual se incluyeron pacientes con aneurismas cerebrales no rotos tratados por vía endovascular con stents diversores y no diversores de flujo, en manejo con aspirina y clopidogrel o con aspirina y ticagrelor como antiagregante. Resultados. En total se incluyeron 148 pacientes con aneurismas intracraneales no rotos con stents diversores y no diversores de flujo. Todos iniciaron DAPT con aspirina más clopidogrel, sin embargo, se suspendió en 24 pacientes por presentar baja respuesta al clopidogrel en el test del VerifyNow y se modificó la terapia a aspirina más ticagrelor. Se presentó una complicación trombótica inmediata en el grupo de clopidogrel (0,81%) y ninguna en el grupo de ticagrelor (0,00%). Así también, una complicación hemorrágica inmediata en el grupo de clopidogrel (0,81%) y ninguna en el grupo de ticagrelor (0,00%). En el seguimiento a 6 meses, 4 pacientes (3,15%) del grupo de clopidogrel, presentaron complicaciones trombóticas y ningún paciente en el grupo de ticagrelor (0,00%). En cuanto a las complicaciones hemorrágicas a 6 meses, se observaron en 4 pacientes (3,23%) del grupo de clopidogrel y en 1 paciente (4,17%) del grupo de ticagrelor. Conclusión. Según nuestro estudio el ticagrelor más aspirina es una alternativa segura y eficaz como DAPT en comparación con el clopidogrel más aspirina, ya que no se presentaron complicaciones tromboembólicas en el grupo de ticagrelor más aspirina.EspecializaciónIntroduction. Thromboembolic events are one of the most important complications in neuroendovascular procedures. The evidence for dual antiplatelet therapy (DAPT) using the aspirin and ticagrelor regimen to prevent them is insufficient compared to DAPT with aspirin and clopidogrel. Methodology. A retrospective cohort study was conducted between April 1, 2015 and December 30, 2020, which included patients with unruptured cerebral aneurysms treated endovascularly with diverse and non-various flow stents, managed with aspirin. and clopidogrel or with aspirin and ticagrelor as an antiaggregant. Results. A total of 148 patients with unruptured intracranial aneurysms with diverse and non-flow diverse stents were included. All began DAPT with aspirin plus clopidogrel, however, DAPT was discontinued in 24 patients due to poor response to clopidogrel in the VerifyNow test, and therapy was changed to aspirin plus ticagrelor. One immediate thrombotic complication occurred in the clopidogrel group (0.81%) and none in the ticagrelor group (0.00%). Also, one immediate bleeding complication in the clopidogrel group (0.81%) and none in the ticagrelor group (0.00%). At 6-month follow-up, 4 patients (3.15%) in the clopidogrel group developed thrombotic complications and no patients in the ticagrelor group (0.00%). Regarding bleeding complications at 6 months, they were observed in 4 patients (3.23%) in the clopidogrel group and in 1 patient (4.17%) in the ticagrelor group. Conclution. According to our study, ticagrelor plus aspirin is a safe and effective alternative as DAPT compared to clopidogrel plus aspirin, since there were no thromboembolic complications in the ticagrelor plus aspirin group.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Comparación de las complicaciones del tratamiento endovascular en pacientes con aneurismas cerebrales no rotos y su relación con el protocolo de antiagregación plaquetaria usado, basados en los resultados del VerifyNow®Comparison of complications of endovascular treatment in patients with unruptured cerebral aneurysms and their relationship with the antiplatelet protocol used, based on the results of VerifyNow®Thesisinfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMEspecialista en Radiología IntervencionistaUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Radiología IntervencionistaMedical sciencesHealth sciencesVascular diseasesAneurysmEndovascular proceduresSalicylic acidAnti-inflammatory agentsCardiovascular systemEmbolismThrombophlebitisCiencias médicasEnfermedades vascularesAcido salicílicoAgentes antiinflamatoriosSistema cardiovascularEmboliaTromboflebitisCiencias de la saludAneurismaClopidogrelTicagrelorProcedimientos endovasculares1. 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Chien S-C, Chen C-C, Chen C-T, Wang AY-C, Hsieh P-C, Yeap M-C, et al. Ticagrelor versus clopidogrel in stent-assisted coil embolization of unruptured intracranial aneurysms. Interventional Neuroradiology. 2021 Nov 18;159101992110549. Available from: https://journals.sagepub.com/doi/abs/10.1177/1591019921105495921. Gurbel PA, Tantry US. Aspirin and clopidogrel resistance: consideration and management. Journal of Interventional Cardiology [Internet]. 2006 Oct 1;19(5):439– 48. Available from: https://pubmed.ncbi.nlm.nih.gov/17020569/22. Serebruany VL, Steinhubl SR, Berger PB, Malinin AI, Bhatt DL, Topol EJ. Variability in platelet responsiveness to clopidogrel among 544 individuals. Journal of the American College of Cardiology [Internet]. 2005 Jan 18;45(2):246–51. Available from: https://www.sciencedirect.com/science/article/pii/S0735109704020686?via%3Dihub23. Kuliczkowski W, Witkowski A, Polonski L, Watala C, Filipiak K, Budaj A, et al. 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Available from: http://www.ajnr.org/content/42/9/163ORIGINAL2022_Tesis_Kevin_David_Hurtado (2).pdf2022_Tesis_Kevin_David_Hurtado (2).pdfTesisapplication/pdf164387https://repository.unab.edu.co/bitstream/20.500.12749/16047/1/2022_Tesis_Kevin_David_Hurtado%20%282%29.pdf1115c17d0dfc87b549b1102348fb7734MD51open access2022_Presentacion_Kevin_David_Hurtado.pdf2022_Presentacion_Kevin_David_Hurtado.pdfPresentaciónapplication/pdf792021https://repository.unab.edu.co/bitstream/20.500.12749/16047/2/2022_Presentacion_Kevin_David_Hurtado.pdf741cf50e87e443a745cf0b6000655debMD52open access2022_Licencia_Kevin_Hurtado.pdf2022_Licencia_Kevin_Hurtado.pdfLicenciaapplication/pdf113484https://repository.unab.edu.co/bitstream/20.500.12749/16047/3/2022_Licencia_Kevin_Hurtado.pdfb1c3a8b3ab065efc462cbe812e69ada3MD53metadata only accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8829https://repository.unab.edu.co/bitstream/20.500.12749/16047/4/license.txt3755c0cfdb77e29f2b9125d7a45dd316MD54open accessTHUMBNAIL2022_Tesis_Kevin_David_Hurtado (2).pdf.jpg2022_Tesis_Kevin_David_Hurtado (2).pdf.jpgIM Thumbnailimage/jpeg7908https://repository.unab.edu.co/bitstream/20.500.12749/16047/5/2022_Tesis_Kevin_David_Hurtado%20%282%29.pdf.jpg913d9fd5cb2125aa78eed93c6168eb58MD55open access2022_Presentacion_Kevin_David_Hurtado.pdf.jpg2022_Presentacion_Kevin_David_Hurtado.pdf.jpgIM Thumbnailimage/jpeg8837https://repository.unab.edu.co/bitstream/20.500.12749/16047/6/2022_Presentacion_Kevin_David_Hurtado.pdf.jpg8cd3208fd5aa0e6a17a6aed655b59054MD56open access2022_Licencia_Kevin_Hurtado.pdf.jpg2022_Licencia_Kevin_Hurtado.pdf.jpgIM Thumbnailimage/jpeg10044https://repository.unab.edu.co/bitstream/20.500.12749/16047/7/2022_Licencia_Kevin_Hurtado.pdf.jpg0fc48e515372ccad771b38061889a813MD57metadata only access20.500.12749/16047oai:repository.unab.edu.co:20.500.12749/160472022-05-03 17:23:37.35open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.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