PMID- 35364131
OWN - NLM
STAT- MEDLINE
DCOM- 20230130
LR  - 20230202
IS  - 0150-9861 (Print)
IS  - 0150-9861 (Linking)
VI  - 50
IP  - 1
DP  - 2023 Feb
TI  - Is it safe to discontinue antiplatelet medication after stent-assisted coil 
      embolization? If so, when is the best time?
PG  - 54-58
LID - S0150-9861(22)00105-5 [pii]
LID - 10.1016/j.neurad.2022.03.009 [doi]
AB  - PURPOSE: Antiplatelet maintenance after stent-assisted coil embolization (SACE) 
      is generally considered essential to avoid post-procedural thromboembolic 
      complications. However, there is still debate as to whether it is safe to 
      discontinue antiplatelet drugs after SACE or when is the best time to do so. We 
      investigate herein the clinical outcomes experienced by patients who discontinue 
      antiplatelet agents after SACE. METHODS: From a prospective database, we 
      retrieved the data for 120 consecutive patients (harboring 130 aneurysms) in whom 
      antiplatelet agents were discontinued after SACE between January 2010 and 
      December 2019. We defined thromboembolic complications associated with 
      discontinuation as neurologic or radiographic ischemia that occurred within 6 
      months of discontinuation of antiplatelet agents; the lesion was required to be 
      correlated with the stented artery. RESULTS: The mean time of discontinuation of 
      antiplatelet medication was 31.4 +/- 18.3 months after SACE (median, 26 months). 
      The majority of patients stopped antiplatelet medication between 18 and 36 months 
      after SACE (74 patients, 61.6%). Laser-cut closed-cell stent was most commonly 
      applied in 91 aneurysms (70.0%), followed by braided closed-cell (n=29; 22.3 %) 
      and laser-cut open-cell stent 10 (7.7 %). No patients experienced cerebral 
      ischemia related to discontinuation of antiplatelet medication. CONCLUSION: Our 
      preliminary study suggests that it may be safe to discontinue antiplatelet 
      medication after SACE in patients at low risk for ischemia. The optimal time to 
      discontinue might be around 18 to 36 months after SACE. Large cohort-based 
      studies or randomized clinical trials are warranted to confirm these results.
CI  - Copyright (c) 2022 Elsevier Masson SAS. All rights reserved.
FAU - Hong, Noah
AU  - Hong N
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Cho, Young Dae
AU  - Cho YD
AD  - Department of Radiology, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea. Electronic address: 
      aronnn@naver.com.
FAU - Kim, Hyun Sik
AU  - Kim HS
AD  - Department of Radiology, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Pang, Chang Hwan
AU  - Pang CH
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Yoo, Dong Hyun
AU  - Yoo DH
AD  - Department of Radiology, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Kim, Jeong Eun
AU  - Kim JE
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Kim, Kang Min
AU  - Kim KM
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Cho, Won-Sang
AU  - Cho WS
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Lee, Sung Ho
AU  - Lee SH
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
FAU - Kang, Hyun-Seung
AU  - Kang HS
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
DEP - 20220329
PL  - France
TA  - J Neuroradiol
JT  - Journal of neuroradiology = Journal de neuroradiologie
JID - 7705086
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Humans
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - *Intracranial Aneurysm/therapy/drug therapy
MH  - Stents/adverse effects
MH  - Cohort Studies
MH  - *Brain Ischemia/etiology
MH  - *Thromboembolism
MH  - *Embolization, Therapeutic/adverse effects/methods
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Aneurysm
OT  - Antiplatelet
OT  - Coil
OT  - Embolization
OT  - Medication
OT  - Stent
COIS- Conflict of interest We declare that we have no conflict of interest.
EDAT- 2022/04/02 06:00
MHDA- 2023/01/31 06:00
CRDT- 2022/04/01 20:11
PHST- 2022/01/04 00:00 [received]
PHST- 2022/03/23 00:00 [revised]
PHST- 2022/03/23 00:00 [accepted]
PHST- 2022/04/02 06:00 [pubmed]
PHST- 2023/01/31 06:00 [medline]
PHST- 2022/04/01 20:11 [entrez]
AID - S0150-9861(22)00105-5 [pii]
AID - 10.1016/j.neurad.2022.03.009 [doi]
PST - ppublish
SO  - J Neuroradiol. 2023 Feb;50(1):54-58. doi: 10.1016/j.neurad.2022.03.009. Epub 2022 
      Mar 29.