Investigation of Safe Termination of Antiplatelet Therapy after LVIS Stent-assisted Cerebral Aneurysm Coiling

Objective: Patients who undergo stent-assisted cerebral aneurysm coiling require long-term antiplatelet therapy (AT). Recently, the low-profile visualized intraluminal support (LVIS) stent (LS) has been available for cerebral aneurysm treatment in Japan as a new design braided stent with excellent wall apposition due to manipulation even if the parent artery is tortuous, like the carotid siphon. The aim of this study was to evaluate whether AT could be terminated without increasing the risk of ischemic events among patients who have undergone LS-assisted cerebral aneurysm coiling.Methods: In all, 15 consecutive patients with 15 unruptured aneurysms who underwent LS-assisted cerebral aneurysm coiling and were confirmed to have neointimal formation by follow-up angiography at 3 months were evaluated in this study. All aneurysms were located in the internal carotid artery (ICA). Dual AT was given for 1 month, and then a single antiplatelet agent was given for 2 months until confirmation of neointimal formation. After confirmation of neointimal formation, AT was terminated. The incidences of ipsilateral ischemic events and stent occlusion, as evaluated by angiography or contrast-enhanced MRA, after termination of AT were prospectively assessed.Results: During follow-up, no ipsilateral ischemic events (mean, 10.3 months; range, 3.1–19.8 months) occurred, and no stent occlusion (mean, 8.0 months; range, 1–17.5 months) was observed in any cases.Conclusion: Termination of the antiplatelet drugs 3 months after the procedure may be safe who underwent LS-assisted coil embolization.