Low risk of intracranial and systemic hemorrhages in patients on dual antiplatelet treatment beyond 1 month following neuroendovascular angioplasty and/or stent placement.
BACKGROUND
Aspirin and clopidogrel treatment beyond 1 month in patients undergoing angioplasty and/or stent placement within the extra- and/or intracranial arteries is not defined.


OBJECTIVE
To determine the incidence of intracranial and systemic bleeding events, recurrent ischemic stroke, and death in patients treated with dual antiplatelets for greater than 1 month.


METHODS
We determined rates of hemorrhage, stroke, or death in consecutive patients with extra- or intracranial lesions, treated with dual antiplatelets after angioplasty and/or stent procedures.


RESULTS
Dual antiplatelet treatment was initiated in 110 patients following endovascular treatment with a median treatment time period of 3 months (364 person-months of exposure). There were two bleeding events (1 intracranial and 1 gastrointestinal), 1 ischemic stroke, and no deaths. The rate of intracranial and systemic bleeding events, recurrent ischemic stroke, death due to stroke, or premature discontinuation was 8.3 per 1,000 person-months (95%, CI [2.7-25.6]). There were no bleeding events after the first month of treatment.


CONCLUSIONS
We did not find an increased risk of adverse events in patients treated with dual antiplatelet treatment beyond 1 month after endovascular procedure, supporting the safety of intermediate-term treatment as adjunct to intra- and extracranial angioplasty and/or stent placement.
Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, MN 55455, USA. ameerehassan@gmail.com
Ameer E
AE
Hassan
Haralabos
H
Zacharatos
Gabriela
G
Vazquez
Gustavo J
GJ
Rodriguez
M Fareed K
MF
Suri
Ramachandra P
RP
Tummala
Robert A
RA
Taylor
Adnan I
AI
Qureshi
D017130:Angioplasty / Q000401:mortality*; D001241:Aspirin / Q000627:therapeutic use*; D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D000077144:Clopidogrel; D003131:Combined Modality Therapy / Q000401:mortality; D015897:Comorbidity; D004359:Drug Therapy, Combination / Q000401:mortality; D064420:Drug-Related Side Effects and Adverse Reactions / Q000401:mortality*; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000000981:diagnostic imaging / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011859:Radiography; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D016019:Survival Analysis; D015996:Survival Rate; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin