Journal of neuroendovascular therapy最新文献

{"title":"Early Antithrombotic Therapy in Acute Ischemic Stroke.","authors":"Masatoshi Koga","doi":"10.5797/jnet.ra.2024-0001","DOIUrl":"10.5797/jnet.ra.2024-0001","url":null,"abstract":"<p><p>Antithrombotic therapy plays a crucial role in secondary prevention following ischemic stroke from the acute phase. Numerous trials, along with a meta-analysis, contributed to establishing aspirin as the primary medication for secondary stroke prevention. According to the Cochrane Database of Systematic Review 2022, initiating antiplatelet therapy with aspirin at a dose of 160 mg to 300 mg daily within 48 hours of stroke onset reduces the risk of death or dependency at the end of follow-up. Other antiplatelet drugs, such as clopidogrel, cilostazol, prasugrel, and intravenous ozagrel sodium, are also available within the Japanese Health Care Insurance System. Two pivotal trials from the 2010s underscored the effectiveness and safety of dual antiplatelet therapy (DAPT) using aspirin and clopidogrel, administered for 21 days to 3 months following acute ischemic stroke or transient ischemic attack. However, the extension of DAPT with aspirin and clopidogrel beyond 3 months may result in substantial bleeding risks. Although prasugrel offers a rapid, potent, and consistent inhibition of platelet aggregation and can be used in place of clopidogrel, there is a lack of substantial real-world clinical data on its use in acute ischemic stroke. It is important to recognize that antiplatelet drugs might not be beneficial and could even increase the risk of hemorrhagic events in cardioembolic stroke. In cases of ischemic stroke with nonvalvular atrial fibrillation, direct oral anticoagulants are the primary choice if applicable. Warfarin continues to be the anticoagulant of choice for secondary stroke prevention in patients with mechanical valve replacements. In patients who have undergone intravenous thrombolysis, antithrombotic therapy is generally delayed for up to 24 hours, although there are no definitive guidelines for the period during and immediately after mechanical thrombectomy. This review provides an overview of the current status of antithrombotic therapy for acute ischemic stroke.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second Coming of Snare-Assisted Stabilization Technique in Cases of Difficult Catheter Access.","authors":"Satoshi Miyamoto, Wataro Tsuruta, Shuhei Egashira, Jun Isozaki, Daiichiro Ishigami","doi":"10.5797/jnet.tn.2025-0040","DOIUrl":"10.5797/jnet.tn.2025-0040","url":null,"abstract":"<p><strong>Objective: </strong>The snare-assisted stabilization technique can address difficult catheter access in cases such as type III aortic arch. This technique can provide additional support to the treatment system, and it has received attention again in the current era of distal access catheter. Because there are a limited number of reports on this technique, the current study showed the details of this technique and also evaluated the usefulness and safety of the snare-assisted stabilization technique.</p><p><strong>Case presentation: </strong>This is a retrospective observational study at a single center. The consequent cases using the snare-assisted stabilization technique from November 2016 to December 2024 were retrospectively reviewed. The main endpoints were morbidity, mortality rate at discharge, and the success ratio of treatments using this technique. This study included 20 patients. The patients' median age was 73 years, and 70% (n = 14) were men. The primary causes of difficult catheter access included torturous or narrow vertebral artery (n = 13, 65%), type III aortic arch (n = 5, 25%), and short-segment common carotid artery proximal to the lesion (n = 2, 10%). The snare-assisted stabilization technique consistently facilitated improved support, resulting in successful procedures in all cases. In 95% (n = 19) of the cases, the procedures were completed without complications.</p><p><strong>Conclusion: </strong>The snare-assisted stabilization technique is effective and safe for improving the guiding system support and addressing catheter access challenges. This technique should come back into the spotlight in the era of distal access catheters.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposal for Reducing the Operator Radiation Exposure Dose during 3D DSA Imaging under Carotid Artery Occlusion Tests (Matas and Alcock Test).","authors":"Katsuya Utsugi, Tomoji Takigawa, Kazuaki Suwa, Masafumi Igarashi, Yuki Komatsuzaki, Ayumu Funaki, Kazunori Kubota","doi":"10.5797/jnet.oa.2025-0024","DOIUrl":"10.5797/jnet.oa.2025-0024","url":null,"abstract":"<p><strong>Objective: </strong>3D DSA performed under carotid artery occlusion tests (Matas and Alcock test) while the operator manually compresses the patient's carotid artery may be performed as a preoperative evaluation. However, few known studies have quantified the operator's radiation exposure dose during 3D DSA under carotid artery occlusion tests. In this study, we measured the changes in the operator's radiation exposure dose during such imaging under different protective measures and assessed alternative protective measures for hand exposure apart from protective gloves and the operator's head and neck orientation, proposing a new protection method.</p><p><strong>Methods: </strong>We measured changes in the operator's radiation exposure dose under different protective measures. Specifically, we measured changes in lens dose on the operator's head and neck orientation and the use of protective equipment. Furthermore, we evaluated alternative protective measures for hand exposure aside from protective gloves.</p><p><strong>Results: </strong>In all measurement points, the lower measured dose was recorded when protective measures were implemented. The measured doses to the left and right lenses varied depending on the usage of protective equipment and the orientation of the operator's head and neck. The lowest measured dose to both lenses was recorded when the protective equipment and ceiling-suspended shield were used, and the operator's head and neck were turned toward the subject. The hand dose was the lowest when protective gloves were used (316.9 μGy), representing a 72% reduction compared with unprotected conditions. When the neck guard or lead plate was inserted underneath the measurement points, the hand dose decreased by approximately 29% (884.3 μGy) and 43% (657.6 μGy), respectively, compared with unprotected conditions.</p><p><strong>Conclusion: </strong>Our findings confirmed that operator radiation exposure dose can be reduced through protective measures. The lens exposure dose was minimized when protective equipment and the ceiling-suspended shield were used, and the operator's head and neck were turned toward the subject. While the protective effect of the lead plates was lower than that of protective gloves-which can be challenging to use during manual compression-the method of inserting a lead plate beneath the patient table and bending it along the shoulder was identified as another useful alternative.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced Radiation Exposure in Treating Wide-Neck Intracranial Bifurcation Aneurysms: Woven EndoBridge versus Stent-Assisted Coiling.","authors":"Yukiko Abe, Michiyasu Fuga, Toshihiro Ishibashi, Shunsuke Hataoka, Katharina Otani, Yuichi Murayama","doi":"10.5797/jnet.oa.2025-0046","DOIUrl":"10.5797/jnet.oa.2025-0046","url":null,"abstract":"<p><strong>Objective: </strong>Compared with stent-assisted coiling (SAC), the Woven EndoBridge (WEB; Terumo Neuro, Aliso Viejo, CA, USA) device has been reported to reduce procedural duration, suggesting the potential to reduce radiation exposure for both patients and operators. However, whether WEB treatment results in lower radiation exposure than SAC has not been fully investigated. This study therefore aimed to evaluate radiation exposure associated with WEB treatment versus SAC in the management of unruptured wide-neck bifurcation aneurysms (WNBAs).</p><p><strong>Methods: </strong>We retrospectively analyzed 46 patients treated for 47 unruptured intracranial aneurysms located at the basilar artery apex, middle cerebral artery bifurcation, or anterior communicating artery at our institution between February 2023 and April 2024. Patients were categorized into 2 groups based on the treatment modality: SAC or WEB device. Radiation exposure, fluoroscopy time, procedure duration, and number of imaging procedures were compared between groups.</p><p><strong>Results: </strong>Baseline characteristics, including age, sex, and aneurysm location, did not differ significantly between groups. However, aneurysms were significantly larger in the WEB group, with both greater median aneurysm volume (61.9 vs. 43.2 mm³, P <0.001) and maximum dome diameter (8.2 vs. 5.4 mm, P <0.001). Radiation exposure was significantly lower in the WEB group, as indicated by lower median values for both air kerma (1888 vs. 3496 mGy, P <0.001) and dose-area product (126.3 vs. 158.9 Gy·cm², P = 0.002). The WEB group also showed significantly shorter values for both fluoroscopy time (49.1 vs. 102.3 min, P = 0.003) and procedure duration (97 vs. 146 min, P = 0.01). The number of imaging procedures and contrast medium volume did not differ significantly between groups.</p><p><strong>Conclusion: </strong>In the endovascular treatment of unruptured WNBAs, the WEB device significantly reduces radiation exposure compared with SAC, primarily by decreasing fluoroscopy time. Given this potential to minimize radiation exposure, the WEB device may be preferable when both methods are clinically viable.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the LEONIS Mova Steerable Catheter in the Treatment of Cavernous Sinus Dural Arteriovenous Fistula with Occluded Inferior Petrosal Sinus.","authors":"Nozomi Harada, Kei Harada, Masahito Kajihara, Kei Arakawa, Kozo Fukuyama","doi":"10.5797/jnet.tn.2024-0105","DOIUrl":"https://doi.org/10.5797/jnet.tn.2024-0105","url":null,"abstract":"<p><strong>Objective: </strong>LEONIS Mova high-flow type (SB-KAWASUMI LABORATORIES, Kanagawa, Japan) is a steerable microcatheter that enables angle adjustment of the catheter tip using a hand-operated dial, and available as a coaxial microcatheter system with a 1.6-F microcatheter. It was used to navigate an occluded inferior petrosal sinus (IPS) in a patient with cavernous sinus (CS) dural arteriovenous fistula (AVF).</p><p><strong>Case presentation: </strong>A man in his 50s presenting with right eye congestion was diagnosed with dural AVF of the CS with bilateral occluded IPSs. The shunted pouch was located in the medial-lateral part of the right CS, with drainage into the superior ophthalmic vein. Transvenous embolization (TVE) from the femoral vein via the occluded IPS was performed. A 6-F guiding catheter was navigated to the right internal jugular vein, and LEONIS Mova high-flow type combined with a 1.6-F Carnelian MARVELS S microcatheter (Tokai Medical Products, Aichi, Japan) was navigated to the occluded IPS. The LEONIS Mova successfully engaged the IPS, and its tip was fixed by adjusting the curve. The microcatheter advanced smoothly into the right CS. After releasing the fixation of the LEONIS Mova, the microcatheter was advanced further into the CS, where the LEONIS Mova was once again fixed. The microcatheter was easily navigated to the shunted pouch, and targeted coil embolization of the shunted pouch, achieving complete occlusion of the dural AVF.</p><p><strong>Conclusion: </strong>The LEONIS Mova steerable catheter offers flexible angle adjustment and strong support for catheter navigation within an occluded IPS during TVE for CS-dural AVF.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Sodium Levels to Predict Endovascular Treatment-Needed Vasospasm Following Low-Grade Aneurysmal Subarachnoid Hemorrhage: A Retrospective Multicenter Study.","authors":"Shuhei Yamada, Hajime Nakamura, Tomofumi Takenaka, Yohei Nakamura, Tomohiko Ozaki, Jiro Iba, Masatoshi Takagaki, Takeo Nishida, Shingo Toyota, Toshiyuki Fujinaka, Takuyu Taki, Haruhiko Kishima","doi":"10.5797/jnet.oa.2024-0078","DOIUrl":"10.5797/jnet.oa.2024-0078","url":null,"abstract":"<p><strong>Objective: </strong>Symptomatic vasospasm (SVS) affects the outcomes of patients with subarachnoid hemorrhage (SAH) and often requires endovascular treatment. Hyponatremia is a predictor of SVS; however, no guidelines have recommended an absolute serum sodium value for SVS prevention. This study aimed to identify factors that influence SVS in patients with low-grade SAH and determine a specific threshold of serum sodium level that predicts SVS.</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective study of 216 patients with aneurysmal SAH grades I-III (World Federation of Neurological Societies scale). Patients were divided into the endovascular treatment-needed vasospasm (etVS) group (n = 29) and non-etVS group (n = 187). The minimum serum sodium level (minNa) was determined in the initial 2 weeks after SAH onset.</p><p><strong>Results: </strong>The minNa of the etVS group (median 132 mmol/L) was significantly lower compared to that of the non-etVS group (median 136 mmol/L) (p <0.001). The receiver operating characteristic curve revealed that a threshold minNa of 133 mmol/L predicted the development of etVS (sensitivity 0.797 and specificity 0.552), and the area under the curve was 0.703 (95% confidence interval [CI]: 0.591-0.815). The odds ratios for etVS in patients with a minNa ≤128 mmol/L and 129-132 mmol/L were 6.79 (95% CI: 2.24-20.51) and 2.96 (95% CI: 0.90-9.73), respectively, when compared to those with a minNa 133-136 mmol/L.</p><p><strong>Conclusion: </strong>Serum sodium levels were a predictor of etVS in patients with low-grade SAH. This is the first study to identify a threshold of serum sodium level for predicting etVS, aiding clinicians in setting a management goal for SVS prevention.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of <i>N</i>-Butyl-2-Cyanoacrylate Embolization of a Lateral Posterior Choroidal Artery Aneurysm Associated with Internal Carotid Artery Occlusion.","authors":"Takashi Aoka, Kei Yanai, Satoshi Koizumi, Hiroki Okabe, Nozomi Otsuka, Katsuya Sato, Gakushi Yoshikawa","doi":"10.5797/jnet.cr.2024-0077","DOIUrl":"10.5797/jnet.cr.2024-0077","url":null,"abstract":"<p><strong>Objective: </strong>A ruptured aneurysm rarely causes a primary intraventricular hemorrhage. Cases of aneurysms concomitant with internal carotid artery occlusion are occasionally reported; however, no previous studies have described lateral posterior choroidal artery (LPChA)-associated aneurysms with internal carotid artery occlusion.</p><p><strong>Case presentation: </strong>We experienced a case of intraventricular hemorrhage caused by the rupture of an LPChA aneurysm associated with the collateral circulation of internal carotid artery occlusion. After a detailed preoperative imaging study, the embolization was successfully achieved using n-butyl-2-cyanoacrylate without new neurological deficits.</p><p><strong>Conclusion: </strong>This case highlights the importance of knowledge of the functional anatomy of collateral anastomosis of the intraventricular choroidal arteries, which allowed safe and successful embolization of the aneurysm.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11865000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe Reversible Cerebral Vasospasm Syndrome Successfully Treated with Balloon Angioplasty and Intra-Arterial Nicardipine Infusion: A Case Report.","authors":"Yoshito Sugita, Yohei Takenobu, Noriko Nomura, Takeshi Kawauchi, Akihiro Okada, Tao Yang, Kenji Hashimoto","doi":"10.5797/jnet.cr.2024-0061","DOIUrl":"10.5797/jnet.cr.2024-0061","url":null,"abstract":"<p><strong>Objective: </strong>Reversible cerebral vasospasm syndrome (RCVS) is characterized by multiple reversible convulsions of the cerebral arteries, accompanied by recurrent, thunderclap-like headaches. The prognosis of most patients is favorable; however, extensive cerebral infarction may result in significant disability or mortality in approximately 5% of cases. Endovascular treatment may be a therapeutic option for patients who do not respond to medical therapy. However, there is a paucity of detailed studies addressing this procedure.</p><p><strong>Case presentation: </strong>A 33-year-old woman presented with severe headache and elevated blood pressure during parturition, resulting in a decreased level of consciousness for 2 days postpartum. Head imaging revealed an intracerebral hemorrhage in the right caudate head nucleus and severe multiple stenoses of the cerebral vessels, leading to a diagnosis of RCVS. Despite treatment with verapamil and magnesium, complete paralysis of both lower limbs, the right upper limb, and aphasia developed on postpartum day 8 (day P8). Nicardipine was injected into the bilateral internal carotid arteries (ICAs) and vertebral arteries, and balloon angioplasty was performed at the tips of the bilateral ICA. Symptoms recurred, and the same nicardipine injection was administered on days P9 and P10. Vasoconstriction gradually improved, no major cerebral infarction occurred, and the patient was able to walk (modified Rankin Scale score, 1) by day P90.</p><p><strong>Conclusion: </strong>Despite medical treatment, there are cases of extensive cerebral infarction due to strong vasoconstriction, and the postpartum period is a risk factor. Endovascular treatment is an effective option for severe RCVS.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11851023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anomalous Origin of the Right Vertebral Artery from the Right Common Carotid Artery Was Uncovered during an Allcock's Test.","authors":"Ryousuke Orimoto, Kouichi Ebihara, Michihiro Hayasaka","doi":"10.5797/jnet.ai.2024-0024","DOIUrl":"10.5797/jnet.ai.2024-0024","url":null,"abstract":"","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antiplatelet Therapy in Endovascular Treatment of Cerebral Aneurysms.","authors":"Hirofumi Matsubara, Yusuke Egashira, Yukiko Enomoto","doi":"10.5797/jnet.ra.2024-0016","DOIUrl":"10.5797/jnet.ra.2024-0016","url":null,"abstract":"<p><p>Thromboembolism is one of the main causes of severe complications in the endovascular treatment of cerebral aneurysms, and antiplatelet therapy (APT) is necessary to prevent such complications. Conversely, prolonged APT has the potential risk of hemorrhagic complications; therefore, the timing of dose reduction or discontinuation is an important aspect of periprocedural APT. However, no clinical evidence of an optimal regimen of APT for cerebral aneurysms exists, and the selection, dosage, duration, or combination of antiplatelets has been dependent on physicians for unruptured or ruptured cerebral aneurysms. Many reports have shown that preoperative APT can reduce ischemic complications without increasing hemorrhagic complications, and some reports have shown that the P2Y12 reaction unit (PRU) value measured using the VerifyNow (Werfen, Barcelona, Spain) system is associated with periprocedural ischemic and hemorrhagic complications. Appropriate dose and duration management adjustments based on the platelet reactivity test, aneurysm morphology, treatment, and patient background may contribute to good outcomes. Although accumulating evidence exists regarding the efficacy of preoperative APT, there is no evidence regarding the optimal duration or discontinuation of APT.</p>","PeriodicalId":73856,"journal":{"name":"Journal of neuroendovascular therapy","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}