PMID- 37778045
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231102
IS  - 1092-0684 (Electronic)
IS  - 1092-0684 (Linking)
VI  - 55
IP  - 4
DP  - 2023 Oct
TI  - Delayed ischemic events with low-dose prasugrel medication for stent-assisted 
      coil embolization in intracranial aneurysm patients.
PG  - E12
LID - 10.3171/2023.7.FOCUS22654 [doi]
AB  - OBJECTIVE: Much emphasis has been put on the use of antiplatelet medication for 
      the prevention of ischemic events in the treatment of cerebral aneurysms with 
      stent assistance. In this regard, the effectiveness and safety of a low-dose 
      prasugrel regimen during the periprocedural period was recently reported. The 
      purpose of this study was to present the outcomes of patients on low-dose 
      prasugrel regimens during the follow-up period after stent-assisted coil 
      embolization (SACE) of cerebral aneurysms. METHODS: For the 396 consecutive 
      patients undergoing SACE procedures, low-dose prasugrel therapy (5 mg of 
      prasugrel and 100 mg of aspirin) was recommended for 3 months after the 
      endovascular treatment. The authors performed a retrospective review of a 
      single-center experience focusing on delayed ischemic events beyond 1 month after 
      treatment. The mean follow-up period was 24.6 +/- 11.3 months. RESULTS: In this 
      cohort of patients on a low-dose prasugrel regimen, cerebral infarction occurred 
      in 1 patient (0.3%, 95% CI 0%-1.8%) beyond 1 month after SACE. No intracranial 
      hemorrhage occurred. Overall ischemic events occurred in 14 patients (3.5%, 95% 
      CI 2.1%-5.9%), all within 6 months of the coiling procedure. All patients had 
      transient symptoms. The events occurred within 2 months after cessation of 
      prasugrel in 11 patients (78.6%). Prasugrel maintenance for 6 months was found to 
      result in lower ischemic events compared with maintenance for 3 months. 
      CONCLUSIONS: For patients undergoing SACE, a low-dose prasugrel regimen was a 
      safe and reliable treatment option for the prevention of delayed ischemic events. 
      Transient ischemic events often occurred within 2 months of stopping prasugrel 
      medication.
FAU - Choi, Hyun Ho
AU  - Choi HH
AD  - 1Department of Neurosurgery, Chung-Ang University Hospital, Chung-Ang University 
      College of Medicine, Seoul, Republic of Korea.
FAU - Lee, Heui Seung
AU  - Lee HS
AD  - 2Department of Neurosurgery, Hallym University Medical Center, Hallym University 
      College of Medicine, Anyang-si, Gyeonggi-do, Republic of Korea; and.
FAU - Lee, Sung Ho
AU  - Lee SH
AD  - 3Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Republic of Korea.
FAU - Kim, Kangmin
AU  - Kim K
AD  - 3Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Republic of Korea.
FAU - Cho, Won-Sang
AU  - Cho WS
AD  - 3Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Republic of Korea.
FAU - Kim, Jeong Eun
AU  - Kim JE
AD  - 3Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Republic of Korea.
FAU - Kang, Hyun-Seung
AU  - Kang HS
AD  - 3Department of Neurosurgery, Seoul National University Hospital, Seoul National 
      University College of Medicine, Seoul, Republic of Korea.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurg Focus
JT  - Neurosurgical focus
JID - 100896471
RN  - G89JQ59I13 (Prasugrel Hydrochloride)
RN  - 0 (Platelet Aggregation Inhibitors)
SB  - IM
MH  - Humans
MH  - Prasugrel Hydrochloride/adverse effects
MH  - *Intracranial Aneurysm/diagnostic imaging/drug therapy/surgery
MH  - *Embolization, Therapeutic/adverse effects/methods
MH  - Platelet Aggregation Inhibitors/adverse effects
MH  - Stents/adverse effects
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - aneurysm
OT  - coil embolization
OT  - medication
OT  - prasugrel
OT  - stent
EDAT- 2023/10/01 18:41
MHDA- 2023/11/02 12:45
CRDT- 2023/10/01 17:52
PHST- 2022/12/06 00:00 [received]
PHST- 2023/07/26 00:00 [accepted]
PHST- 2023/11/02 12:45 [medline]
PHST- 2023/10/01 18:41 [pubmed]
PHST- 2023/10/01 17:52 [entrez]
AID - 10.3171/2023.7.FOCUS22654 [doi]
PST - ppublish
SO  - Neurosurg Focus. 2023 Oct;55(4):E12. doi: 10.3171/2023.7.FOCUS22654.