BackgroundAlthough stent-assisted coiling embolization (SAC) has been associated with a higher risk of ischemic and hemorrhagic complications, the use of SAC continues to rise for treating ruptured intracranial aneurysms (RIAs). This study aims to assess the safety and effectiveness of dual antiplatelet therapy (DAPT) in the context of RIAs.MethodsWe conducted a retrospective analysis at a single center, involving patients with aneurysmal subarachnoid hemorrhage (aSAH) between May 1, 2017 and December 31, 2021. Patients were categorized into two groups: the SAC group and the non-SAC (NSC) group. Patients in the SAC group received DAPT. We compared modified Rankin Scale (mRS) score, along with hemorrhagic and ischemic complications, between the two groups to evaluate the safety and efficacy of DAPT for SAC.ResultsThe study included a total of 541 patients, of whom 38 (7.0%) experienced hemorrhagic complications and 48 (8.9%) developed ischemic complications. Additionally, 99 (18.3%) and 84 (15.5%) had poor clinical outcomes at discharge and 6 months, respectively. However, no statistically significant differences were observed between the two groups. Our analysis revealed that aneurysm location in the posterior circulation was a significant risk factor for an unfavorable prognosis when antiplatelet drugs were used following SAC ( p = 0.025).ConclusionsAdministering antiplatelet drugs after SAC for RIAs has demonstrated both safety and effectiveness. However, caution should be exercised when considering this treatment strategy for RIAs located in the posterior circulation due to the potentially elevated risk.

中文翻译：

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双联抗血小板药物支架辅助栓塞对颅内动脉瘤破裂患者脑卒中风险及预后的安全性和有效性：CIAP-5临床试验一中心结果

背景尽管支架辅助弹簧圈栓塞 (SAC) 与较高的缺血性和出血性并发症风险相关，但 SAC 在治疗破裂颅内动脉瘤 (RIA) 中的使用持续增加。本研究旨在评估 RIA 背景下双重抗血小板治疗 (DAPT) 的安全性和有效性。方法我们在单中心进行了回顾性分析，纳入 2017 年 5 月 1 日至 12 月 31 日期间动脉瘤性蛛网膜下腔出血 (aSAH) 患者， 2021年。患者被分为两组：SAC组和非SAC（NSC）组。SAC 组患者接受 DAPT。我们比较了两组之间的改良 Rankin 量表 (mRS) 评分以及出血和缺血并发症，以评估 DAPT 治疗 SAC 的安全性和有效性。结果该研究总共纳入 541 名患者，其中 38 名 (7.0%) 经历过出血并发症，48 例（8.9%）出现缺血性并发症。此外，分别有 99 名 (18.3%) 和 84 名 (15.5%) 患者在出院时和 6 个月内临床结果不佳。然而，两组之间没有观察到统计学上的显着差异。我们的分析显示，当 SAC 后使用抗血小板药物时，后循环动脉瘤位置是不良预后的重要危险因素 (p = 0.025)。 结论 SAC 后给予抗血小板药物进行 RIA 已被证明是安全性和有效性的。然而，由于潜在的风险升高，在考虑对位于后循环的 RIA 进行这种治疗策略时应谨慎行事。