• Kevin D Hurtado-Ortiz, Andres F Ortiz-Giraldo, D Vera-CamargoDanielaDInterventional Radiology Department, Fundación Oftalmológica de Santander - Clínica Ardila Lülle, Floridablanca, Colombia; Radiology Department, Fundación Oftalmológica de Santander - Clínica Ardila Lülle, Floridablanca, Colombia., Carolina Valenzuela-Santos, Sauder A Cardenas-Sanchez, Paula A Correa-Ruiz, Carlos A Ferreira-Prada, Melquizidel Galvis, Oliverio Vargas-Pérez, Sergio Serrano-Gómez, Adriana Reyes, and Daniel E Mantilla-Garcia.
• Interventional Radiology Department, Fundación Oftalmológica de Santander - Clínica Ardila Lülle, Floridablanca, Colombia; Radiology Department, Fundación Oftalmológica de Santander - Clínica Ardila Lülle, Floridablanca, Colombia. Electronic address: kevinkorporation@hotmail.com.
• World Neurosurg. 2023 Jun 22.

BackgroundThromboembolic events are critical complications in neuroendovascular procedures, and dual antiplatelet therapy (DAPT) can reduce them. The effects of using aspirin and clopidogrel in DAPT are well characterized, but use of aspirin and ticagrelor has been less studied.MethodsThis retrospective cohort study, conducted between April 1, 2015, and December 30, 2020, included patients with endovascular treatment with flow-diverting and non-flow-diverting stents for unruptured cerebral aneurysms who received DAPT with aspirin and clopidogrel or with aspirin and ticagrelor.ResultsOf 148 patients with unruptured intracranial aneurysms with flow-diverting and non-flow-diverting stents started on DAPT with aspirin (100 mg/day) and clopidogrel (75 mg/day), 24 had a poor response to clopidogrel according to the VerifyNow test and had DAPT changed to aspirin (100 mg/day) and ticagrelor (90 mg every 12 hours). One thrombotic complication (0.81%) and 1 bleeding complication (0.81%) occurred in patients receiving DAPT with clopidogrel and aspirin during the procedure. These complications did not occur (0.00%) in patients receiving DAPT with ticagrelor and aspirin. At the 6-month follow-up, 4 patients (3.15%) in the clopidogrel group presented with thrombotic complications, whereas no patients (0.00%) in the ticagrelor group experienced this complication. At 6-month follow-up, 4 patients (3.23%) in the clopidogrel group presented with hemorrhagic complications, whereas only 1 patient (4.17%) in the ticagrelor group experienced this complication.ConclusionsOur study showed that DAPT with ticagrelor (90 mg every 12 hours) and aspirin (100 mg/day) is a safe and effective alternative to DAPT with clopidogrel (75 mg/day) and aspirin (100 mg/day) for patients with an inadequate response to clopidogrel.Copyright © 2023 Elsevier Inc. All rights reserved.

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