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®

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dc.contributor.advisorMantilla García, Daniel Eduardo
dc.contributor.advisorSerrano Gómez, Sergio
dc.contributor.advisorValenzuela Santos, Carolina
dc.contributor.advisorVera Camargo, Daniela
dc.contributor.advisorFerreira Prada, Carlos
dc.contributor.advisorGalvis, Melquisedec
dc.contributor.advisorVargas Pérez, Oliverio
dc.contributor.advisorReyes, Adriana
dc.contributor.authorHurtado Ortíz, Kevin Davin
dc.contributor.cvlacSerrano Gómez, Sergio [0001521095]spa
dc.contributor.cvlacValenzuela Santos, Carolina [0000125123]spa
dc.contributor.cvlacFerreira Prada, Carlos [0001765305]spa
dc.contributor.googlescholarValenzuela Santos, Carolina [es&oi=ao]spa
dc.contributor.orcidHurtado Ortíz, Kevin Davin [0000-0001-7841-4498]spa
dc.contributor.orcidMantilla García, Daniel Eduardo [0000-0002-5727-3195]spa
dc.contributor.orcidValenzuela Santos, Carolina [0000-0002-2894-5087]spa
dc.contributor.orcidFerreira Prada, Carlos [0000-0002-7068-356X]spa
dc.contributor.orcidGalvis, Melquisedec [0000-0001-6238-9590]spa
dc.contributor.orcidVargas Pérez, Oliverio [0000-0003-3389-711X]spa
dc.contributor.researchgateValenzuela Santos, Carolina [Carolina-Valenzuela-Santos-2211127213]spa
dc.contributor.researchgateGalvis, Melquisedec [Melquisedec-Galvis-2215881795]spa
dc.contributor.researchgateFerreira Prada, Carlos [Carlos-A-Ferreira-Prada-2211147103]spa
dc.contributor.scopusSerrano Gómez, Sergio [57197758865]spa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialFloridablanca (Santander, Colombia)spa
dc.coverage.temporal2015-2020spa
dc.date.accessioned2022-03-24T21:38:51Z
dc.date.available2022-03-24T21:38:51Z
dc.date.issued2022-02
dc.degree.nameEspecialista en Radiología Intervencionistaspa
dc.description.abstractIntroducción. 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.spa
dc.description.abstractenglishIntroduction. 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.spa
dc.description.degreelevelEspecializaciónspa
dc.description.learningmodalityModalidad Presencialspa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/16047
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programEspecialización en Radiología Intervencionistaspa
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombiaspa
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsVascular diseasesspa
dc.subject.keywordsAneurysmspa
dc.subject.keywordsEndovascular proceduresspa
dc.subject.keywordsSalicylic acidspa
dc.subject.keywordsAnti-inflammatory agentsspa
dc.subject.keywordsCardiovascular systemspa
dc.subject.keywordsEmbolismspa
dc.subject.keywordsThrombophlebitisspa
dc.subject.lembCiencias médicasspa
dc.subject.lembEnfermedades vascularesspa
dc.subject.lembAcido salicílicospa
dc.subject.lembAgentes antiinflamatoriosspa
dc.subject.lembSistema cardiovascularspa
dc.subject.lembEmboliaspa
dc.subject.lembTromboflebitisspa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalAneurismaspa
dc.subject.proposalClopidogrelspa
dc.subject.proposalTicagrelorspa
dc.subject.proposalProcedimientos endovascularesspa
dc.titleComparación 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®spa
dc.title.translatedComparison 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®spa
dc.typeThesiseng
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa

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