PMID- 35932268
OWN - NLM
STAT- MEDLINE
DCOM- 20230303
LR  - 20230313
IS  - 1933-0693 (Electronic)
IS  - 0022-3085 (Linking)
VI  - 138
IP  - 3
DP  - 2023 Mar 1
TI  - Antiplatelet therapy discontinuation after stent-assisted coil embolization for 
      intracranial aneurysms: a single-center, long-term, retrospective, observational 
      study.
PG  - 724-731
LID - 10.3171/2022.6.JNS22815 [doi]
AB  - OBJECTIVE: The protocol for antiplatelet therapy after stent-assisted coil 
      embolization (SACE) for intracranial aneurysms is not well established. In 
      particular, the indications for single antiplatelet therapy (SAPT) 
      discontinuation remain controversial. The authors investigated the long-term 
      outcomes of SAPT discontinuation after SACE among patients at a single 
      institution. METHODS: Patients who underwent SACE during the period from 2010 to 
      2020 and who were followed up for > 1 year were included in this study. The 
      delayed ischemic and hemorrhagic complication rates were examined during 
      follow-up. Moreover, the risk factors of antiplatelet therapy reduction or 
      discontinuation and the outcomes of SAPT discontinuation were examined. RESULTS: 
      In total, 240 patients were included in the analysis. The average patient age was 
      60.3 years, and the average follow-up period was 46.7 months. Nine (3.8%) 
      patients presented with symptomatic delayed ischemic complication, and 3 (1.3%) 
      patients experienced a decline in modified Rankin Scale score. The stent 
      configuration (T- or Y-stent) was the only risk factor associated with delayed 
      ischemic complication (p < 0.001). SAPT was discontinued in 147 (71.7%) of 205 
      patients who were followed up for > 2 years, and no ischemic complications were 
      observed. CONCLUSIONS: It is safe to discontinue SAPT in patients without 
      ischemic complications and with stable intraaneurysmal signals on MRA 2 years 
      after SACE. The T- or Y-stent is a high-risk factor for delayed ischemic 
      complications, and antiplatelet therapy reduction or discontinuation should be 
      cautiously considered.
FAU - Goto, Shunsaku
AU  - Goto S
FAU - Izumi, Takashi
AU  - Izumi T
FAU - Nishihori, Masahiro
AU  - Nishihori M
FAU - Imai, Tasuku
AU  - Imai T
FAU - Araki, Yoshio
AU  - Araki Y
FAU - Kanamori, Fumiaki
AU  - Kanamori F
FAU - Uda, Kenji
AU  - Uda K
FAU - Yokoyama, Kinya
AU  - Yokoyama K
FAU - Saito, Ryuta
AU  - Saito R
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20220805
PL  - United States
TA  - J Neurosurg
JT  - Journal of neurosurgery
JID - 0253357
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - *Intracranial Aneurysm/therapy
MH  - Retrospective Studies
MH  - *Embolization, Therapeutic/methods
MH  - Stents/adverse effects
MH  - Treatment Outcome
OTO - NOTNLM
OT  - antiplatelet therapy
OT  - discontinuation
OT  - intracranial aneurysm
OT  - long-term results
OT  - stent-assisted coil embolization
OT  - vascular disorders
EDAT- 2022/08/07 06:00
MHDA- 2023/03/04 06:00
CRDT- 2022/08/06 10:02
PHST- 2022/04/07 00:00 [received]
PHST- 2022/06/02 00:00 [accepted]
PHST- 2022/08/07 06:00 [pubmed]
PHST- 2023/03/04 06:00 [medline]
PHST- 2022/08/06 10:02 [entrez]
AID - 10.3171/2022.6.JNS22815 [doi]
PST - epublish
SO  - J Neurosurg. 2022 Aug 5;138(3):724-731. doi: 10.3171/2022.6.JNS22815. Print 2023 
      Mar 1.