Cangrelor vs. GP IIb/IIIa Inhibitors in MCA Stroke Thrombectomy: Bleeding and Stroke Trade-offs in Stented Patients

In MCA stroke thrombectomy requiring angioplasty/stenting, cangrelor vs GPI showed lower major bleeding (15.3% vs 26.5%; HR 0.53) but higher recurrent stroke (32.7% vs 11.2%; HR 2.57). Overall, no significant differences in bleeding or ICH.

• Overall cohort (302 per group): no significant difference in major bleeding (18.9% vs 24.5%; HR 0.74, p=0.084), ICH, or mortality.
• In the angioplasty/stenting subgroup (98 per group), cangrelor also reduced ICH (14.3% vs 25.5%), hemicraniectomy (17.3% vs 31.6%), and functional dependency (18.4% vs 31.6%).
• Exploratory subgroup analysis; recurrent stroke increase observed at 1-24 months.

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