PMID- 29301051
OWN - NLM
STAT- In-Process
LR  - 20190714
IS  - 1524-4040 (Electronic)
IS  - 0148-396X (Linking)
VI  - 83
IP  - 5
DP  - 2018 Nov 1
TI  - Antiplatelet Premedication for Stent-Assisted Coil Embolization of Intracranial
      Aneurysms: Low-Dose Prasugrel vs Clopidogrel.
PG  - 981-988
LID - 10.1093/neuros/nyx591 [doi]
AB  - BACKGROUND: The use of antiplatelet medications to prevent thrombosis in the
      treatment of cerebral aneurysms with stents has become widely emphasized.
      OBJECTIVE: To compare low-dose prasugrel with clopidogrel in stent-assisted coil 
      embolization of intracranial aneurysms. METHODS: This is a retrospective review
      of 311 aneurysms from 297 patients who underwent stent-assisted endovascular coil
      embolization of unruptured intracranial aneurysm between November 2014 and March 
      2017. Thromboembolic and hemorrhagic adverse events were compared between 207
      patients who received low-dose prasugrel (PSG group) and 90 patients who received
      clopidogrel (CPG group). RESULTS: P2Y12 reaction unit (PRU) values were
      significantly lower in the PSG group (PSG group vs CPG group, 132.3 +/- 76.9 vs
      238.1 +/- 69.1; P < .001); the percentage of inhibition was also statistically
      higher in the PSG group (54.0 +/- 26.0% vs 20.8 +/- 18.6%; P < .001).
      Thromboembolic events occurred less frequently in the PSG group than in the CPG
      group (0.9% vs 6.4%; P = .01), whereas there was no significant difference in the
      percentage of hemorrhagic complications (0.5% vs 2.2%; P = .22). In the
      multivariate analysis, clopidogrel as the antiplatelet medication was the sole
      significant risk factor for thromboembolism in this series of patients undergoing
      stent-assisted coil embolization. CONCLUSION: Use of low-dose PSG as an
      antiplatelet premedication is quick, effective, and safe for stent-assisted coil 
      embolization of unruptured intracranial aneurysms. Prasugrel premedication
      significantly lowered the frequency of thromboembolic events without increasing
      the risk of hemorrhage.
FAU - Choi, Hyun Ho
AU  - Choi HH
AD  - Department of Neurosurgery, Dongk-uk University Hospital, Dongkuk Unive-rsity
      College of Medicine, Ilsan, Korea.
FAU - Lee, Jung Jun
AU  - Lee JJ
AD  - Department of Radiology, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Cho, Young Dae
AU  - Cho YD
AD  - Department of Radiology, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Han, Moon Hee
AU  - Han MH
AD  - Department of Radiology, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Cho, Won-Sang
AU  - Cho WS
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Kim, Jeong Eun
AU  - Kim JE
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - An, Sang Joon
AU  - An SJ
AD  - Department of Radiology, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Mun, Jong Hyeon
AU  - Mun JH
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Yoo, Dong Hyun
AU  - Yoo DH
AD  - Department of Radiology, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
FAU - Kang, Hyun-Seung
AU  - Kang HS
AD  - Department of Neurosurgery, Seoul National University Hospital, Seoul National
      University College of Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurosurgery
JT  - Neurosurgery
JID - 7802914
EDAT- 2018/01/05 06:00
MHDA- 2018/01/05 06:00
CRDT- 2018/01/05 06:00
PHST- 2017/08/05 00:00 [received]
PHST- 2017/11/20 00:00 [accepted]
PHST- 2018/01/05 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
PHST- 2018/01/05 06:00 [entrez]
AID - 4781706 [pii]
AID - 10.1093/neuros/nyx591 [doi]
PST - ppublish
SO  - Neurosurgery. 2018 Nov 1;83(5):981-988. doi: 10.1093/neuros/nyx591.