PMID- 37502664
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230729
IS  - 2186-2494 (Electronic)
IS  - 1882-4072 (Print)
IS  - 1882-4072 (Linking)
VI  - 14
IP  - 10
DP  - 2020
TI  - Strategies to Prevent Ischemic Complications after Stent-assisted Coil 
      Embolization of Cerebral Aneurysms.
PG  - 413-419
LID - 10.5797/jnet.oa.2020-0006 [doi]
AB  - OBJECTIVE: There have been no delayed ischemic complications related to 
      stent-assisted coil embolization (SACE) of cerebral aneurysms at our institution. 
      We demonstrate our strategies for stent placement and postoperative management of 
      antiplatelet therapy to reduce the risk of ischemic complications. METHODS: We 
      analyzed 57 cases of SACE retrospectively. In the procedure, an appropriate stent 
      was selected and placed to fit the arterial wall without impeding on small 
      arterial branches. Two different antiplatelet drugs, including clopidogrel, were 
      used. Six to twelve months after surgery, follow-up angiography was performed to 
      assess the safety of terminating antiplatelet therapy. In cases in which 
      antiplatelet therapy was tapered, the two antiplatelet drugs were switched to 
      clopidogrel alone, and it was subsequently tapered and finally discontinued. 
      RESULTS: There were 49 cases of SACE in which postoperative antiplatelet therapy 
      was tapered. Among these cases, antiplatelet therapy was discontinued in 35 
      cases. The mean duration of dual antiplatelet therapy was 10.6 +/- 2.8 months, and 
      the mean duration of total antiplatelet therapy was 15.0 +/- 2.1 months. Three 
      patients developed SACE-related ischemic stroke, which developed in the early 
      phase after surgery in all. CONCLUSION: Antiplatelet therapy can safely be 
      terminated in most cases of SACE. In order to reduce the risk of ischemic 
      complications, stent selection, stent placement, and management of antiplatelet 
      therapy should be performed appropriately. Furthermore, careful follow-up should 
      be continued even after the termination of antiplatelet therapy.
CI  - (c)2020 The Japanese Society for Neuroendovascular Therapy.
FAU - Higashida, Tetsuhiro
AU  - Higashida T
AD  - Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, 
      Japan.
FAU - Uchida, Takanori
AU  - Uchida T
AD  - Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, 
      Japan.
FAU - Osakabe, Manabu
AU  - Osakabe M
AD  - Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, 
      Japan.
FAU - Takahashi, Yuichi
AU  - Takahashi Y
AD  - Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, 
      Japan.
FAU - Kanazawa, Ryuzaburo
AU  - Kanazawa R
AD  - Department of Neurosurgery, Nagareyama Central Hospital, Nagareyama, Chiba, 
      Japan.
LA  - eng
PT  - Journal Article
DEP - 20200731
PL  - Japan
TA  - J Neuroendovasc Ther
JT  - Journal of neuroendovascular therapy
JID - 101488164
PMC - PMC10370531
OTO - NOTNLM
OT  - antiplatelet therapy
OT  - clopidogrel
OT  - ischemic complications
OT  - stent-assisted coil embolization
COIS- The authors declare no conflicts of interest.
EDAT- 2020/01/01 00:00
MHDA- 2020/01/01 00:01
PMCR- 2020/01/01
CRDT- 2023/07/28 04:19
PHST- 2020/01/18 00:00 [received]
PHST- 2020/05/20 00:00 [accepted]
PHST- 2020/01/01 00:01 [medline]
PHST- 2020/01/01 00:00 [pubmed]
PHST- 2023/07/28 04:19 [entrez]
PHST- 2020/01/01 00:00 [pmc-release]
AID - jnet.oa.2020-0006 [pii]
AID - 10.5797/jnet.oa.2020-0006 [doi]
PST - ppublish
SO  - J Neuroendovasc Ther. 2020;14(10):413-419. doi: 10.5797/jnet.oa.2020-0006. Epub 
      2020 Jul 31.