Clinical neurology and neurosurgery · 2026
Comparative assessment of antiplatelet effects in neurointervention: Cerebral artery stenosis versus intracranial aneurysm.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Jiang Run-Hao, Pan Song, Ding Li-Dong, Wang Jun, Liu Xing-Long, Jia Zhen-Yu, Zhao Lin-Bo, Cao Yue-Zhou, Liu Sheng
Аннотация
OBJECTIVE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor is extensively used in neurointerventional procedures to prevent thromboembolic events. Intracranial aneurysm (IA) and cerebral artery stenosis (CAS) might exhibit different responses to DAPT because they have different pathophysiologies. In the present study, we compared IA and CAS patients in terms of ischemic and hemorrhagic complications after endovascular treatment maintained with DAPT.
METHODS: We conducted a retrospective analysis of patients undergoing neurointerventional procedures at our center between August 2023 and September 2024. Clinical data, including DAPT regimens, baseline characteristics, and complications (ischemic or hemorrhagic), were systematically reviewed. Propensity score matching (PSM) was used to adjust for baseline differences between groups.
RESULTS: A total of 991 patients (556 IA and 435 CAS) were enrolled. While IA patients and CAS patients demonstrated comparable rates of ischemic complications (2.3% vs. 1.1%, P = 0.131), the former showed a significantly higher incidence of hemorrhagic complications than the latter, particularly nuisance bleeding (NB) (45.7% vs. 15.9%, P < 0.001). There were significant differences in the prevalence of atherosclerosis risk factors and baseline characteristics between the two groups. After PSM (232 matched pairs), ischemic event rates remained similar between groups, while hemorrhagic complications remained more frequent in IA patients.
CONCLUSION: Our findings indicate that standard DAPT (aspirin 100 mg/day + clopidogrel 75 mg/day) appears appropriate for CAS patients but may be associated with increased NB risk in IA patients. These results underscore the need for condition-specific antiplatelet strategies in neurointerventional practice.
METHODS: We conducted a retrospective analysis of patients undergoing neurointerventional procedures at our center between August 2023 and September 2024. Clinical data, including DAPT regimens, baseline characteristics, and complications (ischemic or hemorrhagic), were systematically reviewed. Propensity score matching (PSM) was used to adjust for baseline differences between groups.
RESULTS: A total of 991 patients (556 IA and 435 CAS) were enrolled. While IA patients and CAS patients demonstrated comparable rates of ischemic complications (2.3% vs. 1.1%, P = 0.131), the former showed a significantly higher incidence of hemorrhagic complications than the latter, particularly nuisance bleeding (NB) (45.7% vs. 15.9%, P < 0.001). There were significant differences in the prevalence of atherosclerosis risk factors and baseline characteristics between the two groups. After PSM (232 matched pairs), ischemic event rates remained similar between groups, while hemorrhagic complications remained more frequent in IA patients.
CONCLUSION: Our findings indicate that standard DAPT (aspirin 100 mg/day + clopidogrel 75 mg/day) appears appropriate for CAS patients but may be associated with increased NB risk in IA patients. These results underscore the need for condition-specific antiplatelet strategies in neurointerventional practice.