Abstract
The optimal duration of dual-antiplatelet therapy (DAPT) for preventing delayed thromboembolic events (DTEs) remains unclear. We aimed to determine whether longer DAPT provides improved protection against delayed DTEs. This retrospective cohort study included 507 stent-assisted coil embolization procedures using a single stent for unruptured intracranial aneurysms. We performed coarsened exact matching according to the duration of maintenance DAPT. DTEs were defined as any neurologic symptoms concerning the stented vascular territory and occurring at 1 month or later after the procedure. After stratification according to DAPT duration (short-term, <9 months; long-term, ≥9 months), the log-rank test and Z-analysis were performed to evaluate the efficacy of long-term DAPT for preventing DTEs. Of 507 treated patients (median follow-up, 44 months), 25 (4.9%) experienced DTEs at 1 month after the procedure. Among all DTEs, 9 (1.8%) were infarctions confirmed on magnetic resonance imaging. Permanent neurologic deficit (modified Rankin Scale score ≥2) occurred in 2 (0.4%) patients. On procedure-to-event analysis, long-term DAPT was not superior for preventing DTEs. Most events occurred within 1 month of switching from DAPT to single-a...Continue Reading
References
Jan 3, 1991·The New England Journal of Medicine·P W SerruysL Kappenberger
May 1, 1994·Radiology·M P MarksB Lane
Oct 1, 1995·Neurosurgery·M MaseH Katano
Nov 5, 2002·Lancet·Andrew MolyneuxUNKNOWN International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group
Jun 17, 2006·Stroke; a Journal of Cerebral Circulation·Thorsten RiesJens Fiehler
Feb 27, 2007·Lancet·Philip Urban, Edoardo De Benedetti
Sep 28, 2010·Neurosurgery·Hyun-Seung KangChang Wan Oh
Jun 15, 2011·Neurosurgery·J MoccoElad I Levy
Jun 29, 2012·The New England Journal of Medicine·Akio MoritaTakashi Yoshimoto
Jan 18, 2013·The New England Journal of Medicine·Giulio G Stefanini, David R Holmes
Jun 12, 2014·Radiology·Gyojun HwangO-Ki Kwon
Nov 18, 2014·The New England Journal of Medicine·Laura MauriUNKNOWN DAPT Study Investigators
Aug 11, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Felipe N AlbuquerquePatrick W Serruys
Feb 18, 2016·Journal of Korean Neurosurgical Society·Hyoung Soo ByounO-Ki Kwon
Mar 31, 2016·Circulation·Glenn N LevineSidney C Smith
Jun 6, 2016·JACC. Cardiovascular Interventions·Si-Hyuck KangHyo-Soo Kim
Sep 8, 2016·Radiology·Chang Hyeun KimTackeun Kim
Citations
Feb 14, 2020·Clinical Neuroradiology·Philipp DietrichAndreas Simgen
Oct 11, 2020·Acta neurochirurgica·Tackeun KimO-Ki Kwon
Dec 1, 2020·World Neurosurgery·Jun Ki KimYong Sam Shin
Jan 29, 2021·Neurologia Medico-chirurgica·Hisayuki HosooAkira Matsumura
Jun 30, 2021·BMC Neurology·Kenji ShodaToru Iwama
Mar 25, 2020·Journal of Neuroradiology. Journal De Neuroradiologie·Riccardo RussoMauro Bergui