Effect of Different Maintenance Time of Dual Antiplatelet Therapy After Intracranial Aneurysm Stent and Coils Embolization on Delayed Cerebral Ischemia
MA Ke, LIAO Xiao, LU Huadong, et al
Qinzhou First People's Hospital, Guangxi Qinzhou 535000, China
Abstract：Objective: To study the different effects of different maintenance time of dual antiplatelet therapy on delayed cerebral ischemia after intracranial aneurysm stent combined with coils embolization. Methods: A retrospective analysis was conducted towards 208 hospitalized patients with intracranial aneurysms, who had stent combined with spring coil embolization between January 2017 and January 2019. Patients were divided into 3 groups, namely the short-term group (maintenance time 3 months, and n = 63), medium-term group (maintenance time 6 months, and n = 87) and the long term group (maintenance time more than nine months, n = 58).The cumulative incidence of delayed cerebral ischemia in the three groups was observed. Kaplan-Meier method was used to calculate the cumulative incidence of delayed cerebral ischemia in the three groups, and Log-rank method was used for comparison between the three groups. Cox proportional regression model was used to analyze the independent influencing factors of delayed cerebral ischemia. Results: Among the 208 patients with intracranial aneurysm, 11 cases of delayed cerebral ischemia occurred, including 5 cases in the short-term group and 6 cases in the medium-term group. The cumulative incidence of delayed cerebral ischemia was higher in the short-term and medium-term groups than in the long-term group, and the differences were significant (P<0.05). Univariate Cox analysis showed that the main risk factors of delayed cerebral ischemia were dual antiplatelet duration, Raymond grade, tumor neck width > 4mm, history of diabetes and age (P<0.05).Multivariate Cox analysis showed that the independent risk factors of delayed cerebral ischemia were mainly dual antiplatelet duration and Raymond grade (P<0.05). Conclusion: In patients with intracranial aneurysms, the maintenance time of different dual antiplatelet therapy after stent combined with coil embolization is 9 months or more, which can effectively reduce the incidence of delayed cerebral ischemia. The incidence of delayed cerebral ischemia in patients with intracranial aneurysms increases with the increase of Raymond grade.
马可, 廖晓, 吕华东, 苏胜有. 颅内动脉瘤支架结合弹簧圈栓塞术后不同双联抗血小板治疗维持时间对迟发性脑缺血的影响[J]. 河北医学, 2021, 27(6): 995-998.
MA Ke, LIAO Xiao, LU Huadong, et al. Effect of Different Maintenance Time of Dual Antiplatelet Therapy After Intracranial Aneurysm Stent and Coils Embolization on Delayed Cerebral Ischemia. HeBei Med, 2021, 27(6): 995-998.
2021, Vol. 27 
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