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KMID : 1001920220650060765
Journal of Korean Neurosurgical Society
2022 Volume.65 No. 6 p.765 ~ p.771
Optimal Duration of Dual Antiplatelet Therapy after Stent- Assisted Coil Embolization of Unruptured Intracranial Aneurysms : A Prospective Randomized Multicenter Trial
Ban Seung-Pil

Kwon O-Ki
Kim Young-Deok
Kim Bum-Tae
Oh Jae-Sang
Kim Kang-Min
Kim Chang-Hyeun
Kim Chang-Hyun
Choi Jai-Ho
Kim Young-Woo
Lim Yong-Cheol
Byoun Hyoung-Soo
Park Sukh-Que
Chung Joon-Ho
Park Keun-Young
Park Jung-Cheol
Kwon Hyon-Jo
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 short-term 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 (long-term 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 top-performing, 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
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