title: The Safety and Efficacy of Triple Antiplatelet Therapy after Intracranial Stent-Assisted Coil Embolization.
abstract: BACKGROUND
  Stent-assisted coil embolization is effective for intracranial aneurysms, especially for wide-necked aneurysms; however, the optimal antiplatelet regimens for postoperative ischemic events have not yet been established. We aimed at determining the efficacy and safety of a triple antiplatelet therapy regimen after intracranial stent-assisted coil embolization.
  
  
  METHODS
  We retrospectively evaluated patients who underwent stent-assisted coil embolization for unruptured intracranial aneurysms or during the chronic phase of a ruptured intracranial aneurysm (≥ 4 weeks after subarachnoid hemorrhage onset). We recorded the incidence of ischemic and bleeding events 140 days postoperatively.
  
  
  RESULTS
  We assessed 79 cases in patients who received either dual (n = 51) or triple (n = 28) antiplatelet therapy. The duration of triple antiplatelet therapy was 49 ± 29 days. Seven patients in the dual group experienced postoperative ischemic events. Compared to the dual group, the triple group had a similar incidence of postoperative bleeding events but a significantly lower incidence of postoperative ischemic events (P < .05).
  
  
  CONCLUSIONS
  Triple antiplatelet therapy had a significantly lower incidence of postoperative ischemic events and a similar incidence of postoperative bleeding events 140 days postoperatively.
authors.affiliation: Department of Neurosurgery, Tanushimaru Central Hospital, Kurume, Japan. Electronic address: fwip4873@mb.infoweb.ne.jp.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Matsumoto
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Iko
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsutsumi
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Takahumi
authors.initials: T
authors.lastname: Mitsutake
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Eto
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nii
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Kanji
authors.initials: K
authors.lastname: Nakai
authors.affiliation: Department of Neurosurgery, Tanushimaru Central Hospital, Kurume, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Oishi
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikawa
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kazekawa
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Intracranial aneurysm; antiplatelet therapy; ischemic event; stent-assisted coil embolization