PMID- 21990540
OWN - NLM
STAT- MEDLINE
DCOM- 20130702
LR  - 20120830
IS  - 1759-8486 (Electronic)
IS  - 1759-8478 (Linking)
VI  - 4
IP  - 5
DP  - 2012 Sep
TI  - Long-term effects of antiplatelet drugs on aneurysm occlusion after endovascular 
      treatment.
PG  - 345-50
LID - 10.1136/neurintsurg-2011-010111 [doi]
AB  - BACKGROUND: The rates of recanalization and reinterventions after endovascular 
      treatment (EVT) of intracranial aneurysms are unknown. Various risk factors have 
      been suggested including the configuration of the aneurysm and the endovascular 
      technique. Recently, an increasing number of patients have received antiplatelet 
      (AP) drugs periprocedurally, possibly inhibiting early thrombus formation. 
      OBJECTIVE: To assess the impact of AP drugs on the rate of recurrence and 
      reintervention. METHODS: Patients treated at our center were entered into a 
      prospectively conducted database. Those with at least one follow-up angiogram 6 
      months after EVT were selected for the study. The role of AP medication was 
      assessed by statistical analysis. RESULTS: 292 patients with 314 aneurysms (206 
      ruptured) were included. The median follow-up time was 18 months. 129 (41%) were 
      treated with APs (70 with acetylsalicylic acid (ASA), 10 with clopidogrel and 48 
      with both). 107 angiographic aneurysm recurrences were noted and 61 aneurysms 
      were retreated at least once. In a multivariate model only aneurysm size, 
      initially incomplete occlusion and the length of follow-up were significant 
      predictors (p<0.05). No correlation was found between AP administration and 
      recurrences or reinterventions. Interestingly, patients receiving ASA alone were 
      retreated less often (OR 0.187, 95% CI 0.061 to 0.572, p=0.003). CONCLUSION: AP 
      administration is not associated with an increased rate of aneurysm recurrence or 
      reintervention; ASA even seemed to have some beneficial effect. However, 
      confounding factors may include the lack of standardized indications for AP and 
      the small number of patients in the series. A prospectively conducted study is 
      warranted to further clarify the role of AP medication after EVT.
FAU - Platz, Johannes
AU  - Platz J
AD  - Department of Neurosurgery, Goethe University, Frankfurt, Germany. 
      platz@med.uni-frankfurt.de
FAU - Guresir, Erdem
AU  - Guresir E
FAU - Seifert, Volker
AU  - Seifert V
FAU - Vatter, Hartmut
AU  - Vatter H
FAU - Berkefeld, Joachim
AU  - Berkefeld J
LA  - eng
PT  - Journal Article
DEP - 20110907
PL  - England
TA  - J Neurointerv Surg
JT  - Journal of neurointerventional surgery
JID - 101517079
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Adult
MH  - Cerebrovascular Disorders/*drug therapy/etiology
MH  - Databases, Factual
MH  - Endovascular Procedures/adverse effects/*trends
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Intracranial Aneurysm/*drug therapy/*surgery
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*administration & dosage
MH  - Prospective Studies
MH  - Time
MH  - Treatment Outcome
EDAT- 2011/10/13 06:00
MHDA- 2013/07/03 06:00
CRDT- 2011/10/13 06:00
PHST- 2011/10/13 06:00 [entrez]
PHST- 2011/10/13 06:00 [pubmed]
PHST- 2013/07/03 06:00 [medline]
AID - neurintsurg-2011-010111 [pii]
AID - 10.1136/neurintsurg-2011-010111 [doi]
PST - ppublish
SO  - J Neurointerv Surg. 2012 Sep;4(5):345-50. doi: 10.1136/neurintsurg-2011-010111. 
      Epub 2011 Sep 7.