ArticleJournal of neuroendovascular therapy2026
An Uninterrupted DOAC plus Single Antiplatelet Strategy for Carotid Artery Stenting in Patients with Atrial Fibrillation.
Article in Journal of neuroendovascular therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Objective: Periprocedural antithrombotic management in patients with non-valvular atrial fibrillation (NVAF) undergoing carotid artery stenting (CAS) remains controversial. Although dual antiplatelet therapy is the standard regimen for CAS, its combination with a direct oral anticoagulant (DOAC) as triple therapy increases bleeding risk. On the other hand, interruption of DOAC therapy may increase thromboembolic risk. We evaluated the clinical outcomes and feasibility of an uninterrupted dual antithrombotic therapy (DAT) strategy consisting of a DOAC and single antiplatelet therapy (SAPT). Methods: We retrospectively reviewed a case series of 10 patients with NVAF treated between 2018 and 2025 who underwent CAS while continuing DOAC plus SAPT without interruption. In all cases, SAPT (clopidogrel, aspirin, or prasugrel) was initiated at least 2 weeks before the procedure. Platelet function was assessed using the VerifyNow system (Werfen, Bedford, MA, USA). We evaluated baseline clinical characteristics, antithrombotic regimens, platelet reactivity, procedural details, and periprocedural clinical outcomes. Results: The mean CHA Conclusion: Uninterrupted DAT with a DOAC and SAPT may be a feasible periprocedural management strategy for CAS in patients with NVAF, without the need for DOAC interruption or triple therapy.
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