Antiplatelet Therapy for Prevention of Thromboembolic Complications Associated with Coil Embolization of Unruptured Cerebral Aneurysms

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Antiplatelet agents are used during endovascular treatment of cerebral aneurysms to prevent thromboembolic complications.


The aim of this study was to investigate the efficacy of clopidogrel for the prevention of thromboembolic complications during elective coil embolization of unruptured cerebral aneurysms.


Sixty-three patients prospectively received oral clopidogrel 75mg/day from 3 days before and for 1 day after the procedure at our institute (Kohnan Hospital, Sendai, Japan) during 2007.


At 24 hours post-coiling, significantly less high-intensity areas, detected by MRI with diffusion-weighted imaging (MRI-DWI), were observed in clopidogrel-treated patients compared with a historical control cohort of aspirin (acetylsalicylic acid)-treated patients (13/63 [20.6%] vs 27/69 [39.1%]; p = 0.02), primarily due to a statistically significantly lower rate during repair of small (<10mm) lesions (p = 0.008).Also, the rate of periprocedural thromboembolic events was lower in the clopidogrel than the aspirin cohort (2/63 [3.2%] vs 5/69 [7.2%]; p = 0.3).


Clopidogrel was generally well tolerated with no signs of hemorrhagic complications or liver dysfunction.

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