Prasugrel Single Antiplatelet Therapy versus Aspirin and Clopidogrel Dual Antiplatelet Therapy for Flow Diverter Treatment for Cerebral Aneurysms: A Retrospective Multicenter Study

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FIGURE.
A, Rate of all observed thromboembolic procedure- or device-related complications in the SAPT with prasugrel and in the DAPT. B, Rate of permanently disabling thromboembolic procedure- or device-related complications in the SAPT and DAPT groups. C, Rate of hemorrhagic procedure-related complications in the SAPT and DAPT groups. D, Rate of complete aneurysm occlusion at latest follow-up in the SAPT and DAPT groups. E, Rate of adequate aneurysm occlusion at latest follow-up in the SAPT and DAPT groups. F, Rate of intimal hyperplasia and asymptomatic parent artery occlusion in the SAPT and DAPT groups. G, Rate of good functional outcome at the latest follow-up in the SAPT and DAPT groups. H, Thromboembolic complications in surface-modified or conventional FDs.

Table 1:

Main characteristics of the 2 medication groups including patients, aneurysms, and procedure-related characteristics^{^a}

	SAPT	DAPT	P Value
Patient characteristics
No. of patients	90	132
Patient age (yr)	52 (SD, 11.8) (10–74)	56 (SD, 12.9) (14–92)	.555
Sex (female)	59 (65.6%)	101 (76.5%)	<.001^{^b}
Aneurysm characteristics
No. of aneurysms	102	149
Aneurysm size	7.5 (SD, 6.1) (1–32)	6.7 (SD, 5.3) (1–28)	.099
SAH	13 (12.8%)	27 (18.1%)	.020^{^b}
Saccular morphology	81 (81.4%)	109 (75.2%)	.021^{^b}
Anterior circulation	91 (89.2%)	128 (85.9%)	.120^{^b}
Procedural details
No. of procedures	91	133	–
No. of implanted FD (total)	105	148	0.306
No. of implanted FD (with surface-modification)	29 (27.6%)	71 (47.9%)	<.001^{^b}
Additional coiling	14 (13.7%)	29 (19.4%)	.016^{^b}
PTA	–	14 (9.4%)	<.001^{^b}
Previously treated aneurysms	20 (19.6%)	18 (12.1%)	.001^{^b}

Note:—The en dash indicates 0 (0%).
↵a Data are mean (SD) (minimum–maximum) or absolute number of cases (relative frequency in percentages).
↵b Statistically significant.

Table 2:

Comparison of study end points between SAPT and DAPT^{^a}

	SAPT (n = 90)	DAPT (n = 132)	P Value
Complications
Thromboembolic (all)	6	12	.188
Thromboembolic (permanently disabling)	0	5	<.001^{^b}
Hemorrhagic	0	3	.003^{^b}
Intimal hyperplasia/asymptomatic parent artery occlusion	3 (2.9%) mild/3 (2.9%)	6 (4.0%) mild/2 (1.3%)	.768
Radiologic and clinical follow-up
Follow-up duration	18 (SD, 12.3) (3–60)	18 (SD, 12.6) (6–74)	.553
Complete occlusion (RROC I) at latest follow-up	82 (80.4%)	115 (78.2%)	.367
Good clinical outcome at latest clinical follow-up (mRS 0-1)	90 (100%)	116 (87.8%)	<.001^{^b}

↵a Data are mean (SD) (minimum-maximum) or absolute number of cases (relative frequency in percentages).
↵b Statistically significant.