Guided antiplatelet therapy a 'safe and attractive' treatment option for many UIA patients

Patients with unruptured intracranial aneurysm (UIA) who have platelet function monitoring–guided antiplatelet therapy before stent placement are less likely to experience thromboembolic complications, according to new data published in Stroke.

In the analysis, the primary outcome was measured by the composite frequency of ischemic stroke, transient ischemic attack, stent thrombosis, urgent revascularization and cerebrovascular death within seven days following stent implantation. The safety outcome, meanwhile, was the composite frequency of major, minor, or minimal bleeding one month after the procedure.

In the study, 584 UIA patients were screened from July 2019 and August 2020. A total of 314 patients with a mean age of 56 years old were enrolled.

While 157 patients were randomly chosen to undergo platelet function monitoring–guided antiplatelet therapy, another 157 patients underwent conventional therapy. 

Overall, the frequency of thromboembolic events was significantly lower in the monitoring group (5.1%) than in the conventional therapy group (12.1%).

Also, ischemic stroke was seen in 4.5% of patients in the monitoring group 12.1% of the conventional therapy groups. There was no significant difference between the two groups when it came to the other kinds of ischemic events (stent thrombosis, urgent revascularization, transient ischemic attack, and death from cerebrovascular causes).

The study's safety outcome, however, was observed more in the monitoring group (7.0%) than in the conventional group (1.9%). This was primarily due to the fact that minor and minimal bleeding events were much more common among patients int he monitoring group.

"However, the frequency of major bleeding events did not significantly differ between the two groups," wrote lead author Wenqiang Li, MD, a specialist with Beijing Neurosurgical Institute, and colleagues. 

Overall, Li et al. added, these results "suggest that guided antiplatelet therapy may be a safe and attractive alternative treatment option for UIA patients who have undergone stent placement."

Read the full study here.

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