{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T15:37:53Z","timestamp":1753889873589,"version":"3.41.2"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Perioperative dual\u2010antiplatelet therapy for flow diversion limits thromboembolic complications. However, resistance to dual\u2010antiplatelet therapy medications remains a concern for neuroendovascular intervention. To date, there is no standardized approach for resistance to ADP receptor antagonists.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We report a case of ticagrelor resistance for flow diversion of an intracranial aneurysm treated with vorapaxar, as well as a narrative review of the literature for previous cases of ticagrelor resistance.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Flow diversion with the Pipeline embolization device was deployed for a left internal carotid artery blister aneurysm and bilateral internal carotid artery dissecting pseudoaneurysms. The patient had 3 thromboembolic complications while on dual\u2010antiplatelet therapy with ticagrelor or prasugrel, leading to transition of antiplatelet therapy to vorapaxar. At 84 days follow\u2010up, the patient was fully recovered with complete occlusion of the aneurysms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">Our case suggests that vorapaxar is a promising alternative for patients with ticagrelor resistance in flow diversion\u2013treated intracranial aneurysms. High\u2010quality randomized controlled trials are needed to elucidate the safety and efficacy of vorapaxar in neuroendovascular procedures.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.121.000125","type":"journal-article","created":{"date-parts":[[2021,11,19]],"date-time":"2021-11-19T13:07:43Z","timestamp":1637327263000},"source":"Crossref","is-referenced-by-count":1,"title":["Vorapaxar as an Alternative for Ticagrelor Resistance in Neuroendovascular Intervention"],"prefix":"10.1161","volume":"1","author":[{"given":"James C.","family":"Mamaril\u2010Davis","sequence":"first","affiliation":[{"name":"Department of Neurosurgery University of Arizona Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Aguilar\u2010Salinas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Arizona Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo B.","family":"Brasiliense","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Arizona Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Cosgrove","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Arizona Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judy","family":"Dawod","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Arizona Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis M.","family":"Dumont","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Arizona Tucson AZ"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9426-0548","authenticated-orcid":false,"given":"Mohammad","family":"El\u2010Ghanem","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery University of Arizona Tucson AZ"},{"name":"Department of Neurology University of Arizona Tucson AZ"},{"name":"Neuroendovascular Surgery HCA Houston Healthcare, Northwest Medical Center Houston TX"},{"name":"University of Houston College of Medicine Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyz345"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0809171"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx079"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010699"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.12.029"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2015.10.030"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/FPC.0b013e3283385420"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.921502"},{"key":"e_1_3_2_11_2","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1111\/j.1538-7836.2009.03527.x","article-title":"Ticagrelor binds to human P2Y(12) independently from ADP but antagonizes ADP\u2010induced receptor signaling and platelet aggregation","volume":"7","author":"VAN Gienzen JJ","year":"2009","unstructured":"VAN Gienzen JJ, Nilsson L, Berntsson P, Wissing BM, Giordanetto F, Tomlinson W, Greasley PJ. 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