World J Vasc Surg | Volume 1, Issue 1 | Research Article | Open Access

The Efficacy of Ozagrel Sodium as a Rescue or Prophylaxis in the Perioperative Management of Thromboembolism during Coil Embolization of Ruptured and Unruptured Cerebral Aneurysms

Yasuhiro Kawabata*, Norio Nakajima and Hidenori Miyake

Department of Neurosurgery, Kyoto Katsura Hospital, Japan

*Correspondance to: Yasuhiro Kawabata 

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Abstract

Objectives: Thromboembolism is the leading cause of neurological complication in neurointervention. We retrospectively analyzed the incidence and the outcome of thromboembolism and the efficacy of ozagrel sodium during coiling embolization of saccular cerebral aneurysm.
Materials and Methods: Since 2012, we treated 103 patients with 106 aneurysms, in whom 116 procedures were performed. 35 patients were male, and 68 patients were female. The median age was 66.5 years (range 21 to 88). Sixty-two aneurysms were ruptured, and 44 aneurysms were unruptured. In a patient, coil embolization of a ruptured aneurysm and an unruptured aneurysm was performed simultaneously. Retreatment was performed in 12 patients. Ozagrel sodium, a thromboxane A2 synthase inhibitor, was administered as a rescue in 8 patients and as a prophylaxis in 17 patients prior to or during the procedure, and thrombectomy using Penumbra system® was performed in a patient. Functional outcome was assessed using Modified Rankin Scale (MRS).
Results: Thromboembolic events occurred in 27 procedures (23.3%), in 13 of which thromboembolism were symptomatic. Cerebral artery occlusion was observed in 9 patients during and after the procedure, in 6 of whom early recanalization could be achieved. Procedure-related permanent neurological deficit due to thromboembolism was observed in 6 patients (5.2%) exclusively in ruptured group; three of them had fair outcome of MRS 2-3 and other three patients had poor outcome unrelated to thromboembolism. None of 17 patients in whom ozagrel sodium was prophylactically administered had permanent neurological deficits due to thromboembolism. No intracranial bleeding complication was observed after administration of ozagrel sodium.
Conclusion: Ozagrel sodium can be a viable option in the perioperative management of endovascular embolization of ruptured and unruptured cerebral aneurysms.

Citation:

Kawabata Y, Nakajima N, Miyake H. The Efficacy of Ozagrel Sodium as a Rescue or Prophylaxis in the Perioperative Management of Thromboembolism during Coil Embolization of Ruptured and Unruptured Cerebral Aneurysms. World J Vasc Surg. 2018; 1(1): 1006.

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