{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T14:08:55Z","timestamp":1777730935635,"version":"3.51.4"},"reference-count":29,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T00:00:00Z","timestamp":1652313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Interv Neuroradiol"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Intro<\/jats:title>\n                    <jats:p>SARS-CoV-2 (COVID-19) infection is associated with acute ischemic stroke (AIS), which may be due to a prothrombotic state. Early reports have suggested high rates of reocclusion following mechanical thrombectomy (MT) with poor radiographic and clinical outcomes. We report our early experience using intra-procedural antithrombotics to address SARS-CoV-2 reocclusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified 6 patients that experienced early reocclusion after MT for COVID-19-associated AIS through retrospective chart review abstracting their basic demographics, COVID-19 status, and stroke management. All these patients were treated after reocclusion with aspirin and cangrelor intra-procedurally, the latter of which was converted to ticagrelor post-procedurally. Some patients additionally received argatroban infusion intraprocedurally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 54. There were 3 post-procedural and 3 intra-procedural re-occlusions. After repeat thrombectomy and treatment with aspirin and cangrelor, those with post-procedure reocclusion did not show further reocclusion, while those with intra-procedural reocclusion showed radiographic improvement with intraprocedural cangrelor administration. Outcomes for these patients were poor, with a median mRS of 4. Two patients developed petechial hemorrhage of their stroke which was managed conservatively, and one developed a retroperitoneal hemorrhage from femoral access requiring transfusion. There were no patients who developed new parenchymal hematomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>COVID-19 AIS may be associated with a hypercoagulable state which risks malignant reocclusion complicating MT. We found antithrombotic treatment periprocedural cangrelor with or without argatroban transitioned to oral aspirin with ticagrelor to be a viable method for management of these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15910199221097484","type":"journal-article","created":{"date-parts":[[2022,5,18]],"date-time":"2022-05-18T18:58:27Z","timestamp":1652900307000},"page":"540-547","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Dual antiplatelet use in the management of COVID-19 associated acute ischemic stroke reocclusion"],"prefix":"10.1177","volume":"29","author":[{"given":"Joshua","family":"Feler","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5735-2654","authenticated-orcid":false,"given":"Carlin","family":"Chuck","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Poggi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Sweeney","sequence":"additional","affiliation":[{"name":"Department of Hematology-Oncology, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krisztina","family":"Moldovan","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh V.","family":"Jayaraman","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan","family":"McTaggart","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radmehr","family":"Torabi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brown University, The Warren Alpert Medical School, Providence, RI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,5,12]]},"reference":[{"key":"bibr1-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.031217"},{"key":"bibr2-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.031786"},{"key":"bibr3-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25967"},{"key":"bibr4-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030335"},{"key":"bibr5-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1177\/1747493020972922"},{"key":"bibr6-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323586"},{"key":"bibr7-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030574"},{"key":"bibr8-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2021.10.023"},{"key":"bibr9-15910199221097484","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A6750"},{"key":"bibr10-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2020-016220"},{"key":"bibr11-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14817"},{"key":"bibr12-15910199221097484","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25475"},{"key":"bibr13-15910199221097484","unstructured":"Antithrombotic Therapy [Internet]. COVID-19 Treatment Guidelines. [cited 2021 Dec 25]. 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