Department of Radiology, Western Health, 160 Gordon St, 3011, Footscray, Victoria, Australia.
Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Victoria, Australia.
Clin Neuroradiol. 2021 Sep;31(3):545-558. doi: 10.1007/s00062-021-00997-4. Epub 2021 Mar 1.
Endovascular techniques have expanded to include balloon and stent-assistance, flow diversion and individualized endovascular occlusion devices, to widen the treatment spectrum for more complex aneurysm morphologies. While usually well-tolerated by patients, endovascular treatment of intracranial aneurysms carries the risk of complications, with procedure-related ischemic complications being the most common. Several antiplatelet agents have been studied in a neurointerventional setting for both prophylaxis and in the setting of intraprocedural thrombotic complications. Knowledge of these antiplatelet agents, evidence for their use and common dosages is important for the practicing neurointerventionist to ensure the proper application of these agents.Part one of this two-part review focused on basic platelet physiology, pharmacology of common antiplatelet medications and future directions and therapies. Part two focuses on clinical applications and evidence based therapeutic regimens.
血管内技术已经扩展到包括球囊和支架辅助、血流导向和个体化血管内闭塞装置，以拓宽更复杂的动脉瘤形态的治疗范围。虽然通常患者能很好地耐受，但颅内动脉瘤的血管内治疗有发生并发症的风险，与操作相关的缺血性并发症是最常见的。几种抗血小板药物已在神经介入治疗中进行了研究，用于预防和治疗术中血栓性并发症。了解这些抗血小板药物、它们的使用证据和常见剂量对于实践中的神经介入医生来说非常重要，以确保这些药物的正确应用。这篇两部分综述的第一部分重点介绍了血小板的基础生理学、常见抗血小板药物的药理学以及未来的方向和治疗方法。第二部分重点介绍了临床应用和基于证据的治疗方案。
