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Safety and efficacy comparison between OACs plus single antiplatelet and dual antiplatelet therapy in patients with cerebral venous sinus stenosis poststenting

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机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing 100053, Peoples R China [2]Beijing Inst Brain Disorders, Adv Ctr Stroke, Beijing 100053, Peoples R China [3]Peking Univ, Peking Univ Sixth Hosp, Dept Neurol, Inst Mental Hlth, Beijing, Peoples R China [4]Peking Univ Sixth Hosp, Natl Clin Res Ctr Mental Disorders, Beijing, Peoples R China [5]Wayne State Univ, Sch Med, Dept Neurosurg, Detroit, MI USA [6]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing 100053, Peoples R China
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关键词: Cerebral venous sinus stenosis Poststenting Oral anticoagulants Dual antiplatelet

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Background and purpose The present strategies regarding poststent management for cerebral venous sinus stenosis (CVSS) are inconsistent. Herein, we compared the safety and efficacy of oral anticoagulants (OACs) plus single antiplatelet therapy and dual antiplatelet therapy for CVSS poststenting. Methods A real-world observational study conducted from January 2009 through October 2019 enrolled patients who were diagnosed with CVSS and received stenting. Patients were divided into two groups according to the management they received poststenting. Group 1: OACs plus a single antiplatelet agent (clopidogrel 75 mg or aspirin 100 mg) and Group 2: dual antiplatelet therapy (clopidogrel 75 mg plus aspirin 100 mg). The safety (such as major or minor bleeding or venous thrombosis) and efficacy (the incidences of cerebral venous sinus restenosis, intrastent thrombosis, or stent displacement) of the two groups were compared. Results There were a total of 110 eligible patients in the final analysis, including 79 females and 31 males with a mean age of 43.42 +/- 13.23 years. No major bleeding or venous thrombosis occurred in either of the two groups. Two minor bleeding events occurred in group 2 (one with subcutaneous bleeding points in both lower limbs, another with submucosal bleeding in the mouth), whereas no bleeding events occurred in Group 1. In addition, at the 1-year follow-up, one case of intraluminal restenosis and two cases of in-stent thrombi occurred in Group 2, while none occurred in Group 1. Neither stenosis at stent-adjacent segments nor stent migration was detected in either group during the 1-year following stent placement. Conclusion OACs plus single antiplatelet therapy and dual antiplatelet therapy alone are both safe and efficacious management strategies after CVSS stent placement. The former may have more advantages than the latter for inhibiting intrastent thrombosis. However, further research by larger, multicenter clinical trials is needed.

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出版当年[2021]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 临床神经病学
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出版当年[2020]版:
Q3 CLINICAL NEUROLOGY
最新[2023]版:
Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing 100053, Peoples R China [2]Beijing Inst Brain Disorders, Adv Ctr Stroke, Beijing 100053, Peoples R China [3]Peking Univ, Peking Univ Sixth Hosp, Dept Neurol, Inst Mental Hlth, Beijing, Peoples R China [4]Peking Univ Sixth Hosp, Natl Clin Res Ctr Mental Disorders, Beijing, Peoples R China
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通讯机构: [1]Capital Med Univ, Xuanwu Hosp, Dept Neurol, Beijing 100053, Peoples R China [2]Beijing Inst Brain Disorders, Adv Ctr Stroke, Beijing 100053, Peoples R China [6]Capital Med Univ, Xuanwu Hosp, Dept Neurosurg, Beijing 100053, Peoples R China
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