Optimal Duration of Dual Antiplatelet Therapy After Stent-assisted Coiling

Optimal Duration of Dual Antiplatelet Therapy After Stent-assisted Coiling of Unruptured Intracranial Aneurysms: A Prospective Randomized Multicenter Trial

Comparison of duration of dual antiplatelet therapy after stent-assisted coiling of unruptured intracranial aneurysms

The purpose of this study is to compare the incidence of thromboembolic and hemorrhagic complications between 1 and 18 months after stent-assisted coiling according to the duration of use of dual antiplatelet agents (6 months versus 12 months) after stent-assisted coiling of unruptured intracranial aneurysms to determine the optimal duration of use of dual antiplatelet agents.

Inclusion Criteria:

• subjects over 19 years old

• subjects with modified Rankin Scale (mRS) ≤ 2

• subjects with unruptured intracranial aneurysms

• subjects with appropriated aspirin and clopidogrel reaction units after dual antiplatelet preparation (100 mg of aspirin and 75 mg of clopidogrel) for at least 5 days before procedure [measured using VerifyNow]

  1. aspirin reaction unit (ARU) < 550
  2. P2Y12 reaction unit (PRU): 85~219

• subjects who agreed to this study (with informed consent)

Exclusion Criteria:

• subjects with neurological deficits (mRS ≥ 3)
• subjects with an allergic reaction to antiplatelets (aspirin and clopidogrel) or contrast
• subjects with a high risk of hemorrhage such ICH or severe gastric ulceration
• subjects with coagulopathy
• subjects with thrombocytopenia (<100,000/mm3)
• subjects with liver diseases (> 100IU/L of aspartate aminotransferase or alanine aminotransferase)
• subjects with renal diseases (> 2mg/dL of serum creatinine)
• subjects with underlying diseases that need to maintain dual antiplatelet drugs or anticoagulants.
• subjects with a high risk of strokes (atrial fibrillation, over 70% cerebral artery stenosis or cerebral artery occlusion, moyamoya disease, vascular malformations, etc)
• subjects with uncontrolled congestive heart failure or angina
• subjects with malignant tumors
• subjects with a positive pregnancy test (serum or urine)
• subjects who are unconscious at the time of diagnosis.
• subjects who are unable to complete the required follow-ups
• subjects with life-threatening diseases
• subjects with medical conditions with a life expectancy of less than two years
• subjects who are determined to be disqualified by researchers