Feasibility of single antiplatelet therapy after stent assisted coiling for ruptured intracranial aneurysms
10.7461/jcen.2024.E2024.04.002
- Author:
Min-Seok WOO
1
;
Dong-Hun KANG
;
Wonsoo SON
;
Myungsoo KIM
Author Information
1. Department of Neurosurgery, School of Medicine, Kyungpook National University, Daegu, Korea
- Publication Type:Clinical Article
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2024;26(4):365-372
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:In total, 176 stent-assisted coil embolization procedures were investigated. Among them, 77 ruptured and 99 unruptured aneurysms were grouped and compared respectively. In the ruptured group, only SAPT (aspirin) was administered after the procedure. Meanwhile, in the unruptured group, dual antiplatelet therapy (DAPT) (aspirin and clopidogrel) was administered before and after the procedure following standard guidelines. We compared both groups in regards to thromboembolic complications by analyzing post procedural diffusion-weighted images (DWI), hyperacute thrombosis during the procedure, and post-procedural symptoms.
Results:The single antiplatelet therapy ruptured intracranial aneurysm (SAPT-RIA) group had 77 saccular aneurysms (62 ICA, 3 MCA, 4 ACA, 8 posterior circulation) with a mean diameter of 8.07 mm. The dual antiplatelet therapy unruptured intracranial aneurysm (DAPT-UIA) group had 99 aneurysms (81 ICA, 5 MCA, 3 ACA, 10 posterior circulation) with a mean diameter of 6.32 mm. DWI positivity rates were similar between groups, but hyperacute thrombosis was higher in the SAPT-RIA group (10.4%) compared to none in the DAPT-UIA group. Each group had one symptomatic complication.
Conclusions:SAPT could be a viable option for the peri-procedural management of SAC in acutely ruptured cases.
