ArticleJournal of neurointerventional surgery2021
Reduction of thromboembolic complications during the endovascular treatment of unruptured aneurysms by employing a tailored dual antiplatelet regimen using aspirin and prasugrel.
Article in Journal of neurointerventional surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 33 citations in OpenAlex.
- Understanding complication rates in elective endovascular aneurysm repair for consideration of same-day discharge.Neuroradiology · 2026Article
- Safety and hemodynamic efficacy of the LVIS stent in the endovascular treatment of intracranial wide-necked aneurysms: a single-center retrospective study.Chinese neurosurgical journal · 2026Article
- Direct Comparison of Dual Antiplatelet Therapy with Prasugrel or Ticagrelor Versus Clopidogrel in Endovascular Treatment of Intracranial Aneurysms: a Meta-analysis.Clinical neuroradiology · 2026Article
- Periprocedural antiplatelet medication assessed by VerifyNow for neuroendovascular treatment: Comparison of prasugrel with clopidogrel.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Safety of dual antiplatelet therapy using aspirin and low-dose Prasugrel with platelet reactivity testing in flow diverter treatment of intracranial aneurysms.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Adjusting Antiplatelet Therapy Using P2YStroke (Hoboken, N.J.) · 2026Article
- Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms.Frontiers in neurology · 2025Article
- Antiplatelet Therapy and Platelet Activity Testing for Neurointerventional Procedures.Stroke (Hoboken, N.J.) · 2025Review
- Antiplatelet Therapy in Endovascular Treatment of Cerebral Aneurysms.Journal of neuroendovascular therapy · 2025Review
- Cost-effectiveness of platelet function testing in dual antiplatelet therapy decision-making after intracranial aneurysm treatment with flow diversion.Neurosurgical review · 2024Article
- Treatment Outcomes of PED for Unruptured Aneurysms of Internal Carotid Artery: Comparison of PED-Flex and PED-Shield.Neurologia medico-chirurgica · 2024Article
- Surgical Management of Ipsilateral Internal Carotid Artery Stenosis and Unruptured Intracranial Aneurysm: Case Review and Treatment Considerations.Journal of neurological surgery reports · 2024Article
- Variability patterns in dual antiplatelet therapy following endovascular repair of intracranial aneurysms: Insight into regimen heterogeneity and the need for a consensus.Acta neurochirurgica · 2024Review
- Tumor Embolization via the Meningohypophyseal and Inferolateral Trunk in Patients with Skull Base Tumors Using the Distal Balloon Protection Technique.AJNR. American journal of neuroradiology · 2024Article
- Efficacy and Safety of Dual Antiplatelet Therapy with the Routine Use of Prasugrel for Flow Diversion of Cerebral Unruptured Aneurysms.Clinical neuroradiology · 2024Article
- Clinical management of a ruptured intracranial aneurysm.Frontiers in stroke · 2024Review
- Artificial Intelligence and Neurosurgery: Tracking Antiplatelet Response Patterns for Endovascular Intervention.Medicina (Kaunas, Lithuania) · 2023Review
- Use of the Neuroform Atlas stent for wide-necked cerebral aneurysms.Scientific reports · 2023Article
- Factors influencing early obliteration during flow diverter treatment of cerebral aneurysms: Establishment of an early obliteration inhibition score.Fujita medical journal · 2023Article
- Effect of Platelet Function Testing Guidance on Clinical Outcomes for Patients with Intracranial Aneurysms Undergoing Endovascular Treatment.AJNR. American journal of neuroradiology · 2023Review
Corrections and comments
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Authors and funding
19 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThromboembolic complications (TECs) are frequent during the endovascular treatment of unruptured aneurysms. To prevent TECs, dual antiplatelet therapy using aspirin and clopidogrel is recommended for the perioperative period. In patients with a poor response, clopidogrel is a risk factor for TECs. To prevent TECs, our study assessed the stratified use of prasugrel.
methodsPatients who underwent endovascular therapy for unruptured cerebral aneurysms from April 2017 to August 2019 were enrolled in this clinical study and given premedication with aspirin and clopidogrel for 2 weeks prior to the procedure. P2Y12 reaction units (PRU) were measured using the VerifyNow assay on the day before the procedure (tailored group). In subgroups with PRU <240, the clopidogrel dose was maintained (CPG subgroup). In subgroups with PRU ≥240, clopidogrel was changed to prasugrel (PSG subgroup). We compared the occurrence of TECs with retrospective consecutive cases from January 2015 to March 2017 without PRU assessments (non-tailored group). The frequency of TECs within 30 days was assessed as the primary endpoint.
resultsThe tailored and non-tailored groups comprised 167 and 50 patients, respectively. TECs occurred in 11 (6.6%) and 8 (16%) patients in the tailored and non-tailored groups (P=0.048), respectively. The HR for TECs was significantly reduced in the tailored group (HR 0.3, 95% CI 0.11 to 0.81); P=0.017) compared with the non-tailored group.
conclusionThe results suggest that tailored dual antiplatelet therapy medication with PRU significantly reduces the frequency of TECs without increasing hemorrhagic complications.
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