Dual antiplatelet therapy in stent-assisted coil embolization of unruptured intracranial aneurysms: a comparison of ticagrelor and clopidogrel
10.3760/cma.j.issn.1673-4165.2023.04.005
- VernacularTitle:支架辅助弹簧圈栓塞治疗未破裂颅内动脉瘤中的双重抗血小板治疗：替格瑞洛与氯吡格雷的比较
- Author:
Pengjie ZHANG
1
;
Jing CAI
;
Yuhai LIU
;
Jian LI
;
Yang CHEN
;
Fangdi XU
Author Information
1. 潍坊医学院，潍坊 261053
- Keywords:
Intracranial aneurysm;
Endovascular procedures;
Embolization, therapeutic;
Stents;
Platelet aggregation inhibitors;
Clopidogrel;
Ticagrelor;
Treatment outcom
- From:
International Journal of Cerebrovascular Diseases
2023;31(4):264-270
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the safety and efficacy of ticagrelor and clopidogrel in dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms.Methods:Patients with unruptured intracranial aneurysms received stent-assisted embolization in the Department of Neurosurgery, Linyi People's Hospital from January 2021 to June 2022 were retrospectively included. According to the preprocedural dual antiplatelet therapy scheme, they were divided into aspirin+clopidogrel group (clopidogrel group) and aspirin+ticagrelor group (ticagrelor group). The incidence of ischemic and bleeding events was compared between the clopidogrel group and the ticagrelor group at 3 months after procedure. Multivariate logistic regression model was used to analyze independent risk factors for postprocedural ischemic and bleeding events. Results:A total of 195 patients were included. Their age was 58.15±10.11 years and 75 were males (38.5%). There was no statistically significant difference in the incidence of bleeding events (12.8% vs. 5.9%) and ischemic events (14.9% vs. 18.8%) at 3 months after procedure between the ticagrelor group ( n=94) and the clopidogrel group ( n=101). Multivariate logistic regression analysis showed that smoking (odds ratio [ OR] 6.085; 95% confidence interval [ CI] 1.589-13.012; P=0.019], hypertension ( OR 4.547, 95% CI 1.589-13.012; P=0.005), aneurysm at the branch vessel ( OR 3.089, 95% CI 1.122-8.504; P=0.029), and the use of flow diverter ( OR 3.111, 95% CI 1.062-9.110; P=0.038) were the independent risk factors for postprocedural ischemic events. Triglycerides might be an independent risk factor for postprocedural bleeding events ( OR 1.435, 95% CI 0.989-2.082; P=0.057), but did not reach statistical significance. Conclusions:In dual antiplatelet therapy for stent-assisted embolization of unruptured intracranial aneurysms, ticagrelor and clopidogrel have the same safety and efficacy.
