잠시만 기다려 주세요. 로딩중입니다.

Dual antiplatelet treatment associated with reduced risk of symptomatic vasospasm and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage

대한뇌혈관외과학회지 2020년 22권 3호 p.134 ~ 140
선경웅, 박은성, 김대원, 강성돈,
소속 상세정보
선경웅 ( Sun Gyeong-Ung ) - Wonkwang University School of Medicine Department of Neurosurgery
박은성 ( Park Eun-Sung ) - Wonkwang University School of Medicine Department of Neurosurgery
김대원 ( Kim Dae-Won ) - Wonkwang University School of Medicine Department of Neurosurgery
강성돈 ( Kang Sung-Don ) - Wonkwang University School of Medicine Department of Neurosurgery

Abstract


Objective: Cerebral vasospasm and delayed cerebral ischemia (DCI) are considered complications after aneurysmal subarachnoid hemorrhage (aSAH). Several hypotheses involving platelet activation have been asserted in the pathophysiology of cerebral vasospasm and DCI. This study aimed to investigate the effect of dual antiplatelet treatment (DAPT) on symptomatic vasospasm and DCI in patients with aSAH.

Methods: A retrospective study was conducted on patients with aSAH from 2009 to 2018. The patients are divided into 2 groups according to the treatment method such as simple or balloon-assisted coil embolization group (SB coiling), and stent-assisted coil embolization group. Patients treated by SB coiling without DAPT were classified as the control group. Patients who required dual antiplatelet treatment due to stent-assisted coil embolization were classified as DAPT group. The incidence of symptomatic vasospasm and DCI was compared between the two groups.

Results: Of 743 patients with aSAH, 563 patients were treated with clipping, 115 patients treated with SB coiling, and 65 patients receive stent-assisted coiling. Among 115 patients underwent SB coiling, 14 patients were excluded by the exclusion criteria. Total number of control group (SB coiling) was 101, DAPT group (stent-assisted coiling) was 65. Depending on whether or not taking DAPT, the incidence of symptomatic vasospasm was lower in the DAPT group (p=0.010). DCI incidence was also lower in the DAPT group, which was statistically significant (p=0.029).

Conclusions: DAPT reduces the frequency of symptomatic vasospasm and DCI in patients with aSAH in our single-center study. To warranting this topic, further, larger prospective and randomized studies should be needed.

키워드

Subarachnoid hemorrhage; Cerebral vasospasm; Delayed cerebral ischemia; Antiplatelet drug

원문 및 링크아웃 정보

등재저널 정보