Journal article
Impact of duration of dual anti-platelet therapy on risk of complications after stent-assisted coiling of unruptured aneurysms
Journal of neurointerventional surgery
13 Aug 2024
PMID: 39137967
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BackgroundThe optimal duration for dual antiplatelet therapy (DAPT) after stent-assisted coiling (SAC) of intracranial aneurysms is unclear. Longer-term therapy may reduce thrombotic complications but increase the risk of bleeding complications.MethodsA retrospective review of prospectively maintained data at 12 institutions was conducted on patients with unruptured intracranial aneurysms who underwent SAC between January 1, 2016 and December 31, 2020, and were followed ≥6 months postprocedure. The type and duration of DAPT, stent(s) used, outcome, length of follow-up, complication rates, and incidence of significant in-stent stenosis (ISS) were collected.ResultsOf 556 patients reviewed, 450 met all inclusion criteria. Nine patients treated with DAPT <29 days after SAC and 11 treated for 43–89 days were excluded from the final analysis as none completed their prescribed duration of treatment. Eighty patients received short-term DAPT. There were no significant differences in the rate of thrombotic complications during predefined periods of risk in the short, medium, or long-term treatment groups (1/80, 1.3%; 2/188, 1.1%; and 0/162, 0%, respectively). Similarly, no differences were found in the rate of hemorrhagic complications during period of risk in any group (0/80, 0%; 3/188, 1.6%; and 1/162, 0.6%, respectively). Longer duration DAPT did not reduce ISS risk in any group.ConclusionsContinuing DAPT >42 days after SAC did not reduce the risk of thrombotic complications or in-stent stenosis, although the risk of additional hemorrhagic complications remained low. It may be reasonable to discontinue DAPT after 42 days following non-flow diverting SAC of unruptured intracranial aneurysms.
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Details
- Title
- Impact of duration of dual anti-platelet therapy on risk of complications after stent-assisted coiling of unruptured aneurysms
- Creators
- Andrew J Ringer - Mayfield Brain & SpineRicardo A Hanel - New England Baptist HospitalAmmad A Baig - University at Buffalo, State University of New YorkAdnan H Siddiqui - University at Buffalo, State University of New YorkDemetrius Klee Lopes - Advocate Health CareGuilherme Barros - University of WashingtonDavid I Bass - Neurological SurgeryMichael R Levitt - University of WashingtonChristopher C Young - University of WashingtonRyan M Naylor - Mayo ClinicGiuseppe Lanzino - Mayo ClinicR Webster Crowley - Rush UniversityJoseph C Serrone - Loyola University ChicagoPeter T Kan - The University of Texas Medical Branch at GalvestonMandy J Binning - Drexel UniversityErol Veznedaroglu - Drexel UniversityAlan Boulos - Albany Medical Center HospitalRabih Tawk - Jacksonville CollegeEndovasc Neurosurg Res Grp ENRG
- Contributors
- Katherine Woollway (Editor)
- Publication Details
- Journal of neurointerventional surgery
- Publisher
- BMJ Publishing Group Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Web of Science ID
- WOS:001294263000001
- Scopus ID
- 2-s2.0-85204221433
- Other Identifier
- 991021918003404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neuroimaging
- Surgery