J Korean Neurosurg Soc.  2022 Nov;65(6):765-771. 10.3340/jkns.2022.0082.

Optimal Duration of Dual Antiplatelet Therapy after Stent- Assisted Coil Embolization of Unruptured Intracranial Aneurysms : A Prospective Randomized Multicenter Trial

Affiliations
  • 1Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
  • 4Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
  • 5Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea
  • 6Department of Neurosurgery, Pusan National University Yangsan Hospital, Yangsan, Korea
  • 7Department of Neurosurgery, Keimyung University Dongsan Medical Center, Daegu, Korea
  • 8Department of Neurosurgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 9Department of Neurosurgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
  • 10Department of Neurosurgery, Ajou University Medical Center, Ajou University School of Medicine, Suwon, Korea
  • 11Department of Neurosurgery, Chungnam National University Sejong Hospital, Sejong, Korea
  • 12Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
  • 13Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
  • 14Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
  • 15Department of Neurosurgery, Chungnam National University Hospital, Daejeon, Korea

Abstract


Objective
: Stent-assisted coil embolization (SAC) has been increasingly used to treat various types of intracranial aneurysms. Delayed thromboembolic complications are major concerns regarding this procedure, so dual antiplatelet therapy with aspirin and clopidogrel is needed. However, clinicians vary the duration of dual antiplatelet therapy after SAC, and no randomized study has been performed. This study aims to compare the safety and efficacy of long-term (12 months) dual antiplatelet therapy and shortterm dual antiplatelet therapy (6 months) after SAC for patients with unruptured intracranial aneurysms (UIAs).
Methods
: This is a prospective, randomized and multicenter trial to investigate the optimal duration of dual antiplatelet therapy after SAC in patients with UIAs. Subjects will receive dual antiplatelet therapy for 6 months (short-term group) or 12 months (longterm group) after SAC. The primary endpoint is the assessment of thromboembolic complications between 1 and 18 months after SAC. We will enroll 528 subjects (264 subjects in each group) and perform 1 : 1 randomization. This study will involve 14 topperforming, high-volume Korean institutions specializing in coil embolization.
Results
: The trial will begin enrollment in 2022, and clinical data will be available after enrollment and follow-up.
Conclusion
: This article describes that the aim of this prospective randomized multicenter trial is to compare the effect of short-term (6 months) and long-term (12 months) dual antiplatelet therapy on UIAs in patients undergoing SAC, and to find the optimal duration.

Keyword

Endovascular procedures; Intracranial aneurysm; Dual anti-platelet therapy; Stents; Thromboembolism

Figure

  • Fig. 1. Study flowchart.


Reference

References

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