Ticagrelor versus Clopidogrel for Patients Undergoing Endovascular Flow Diversion for Unruptured Intracranial Aneurysms: A Multicenter Investigation - PubMed
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- #intracranial-aneurysm
- #ticagrelor
- #clopidogrel
- Study compares ticagrelor and clopidogrel for patients undergoing flow diversion (FD) for unruptured intracranial aneurysms (UIA).
- Dual antiplatelet therapy is essential for FD treatment, but the optimal P2Y12 inhibitor remains controversial.
- Retrospective propensity score-matched analysis of 2,976 patients (1,047 ticagrelor, 1,929 clopidogrel) from a multicenter database.
- Primary endpoint: ischemic stroke at 180 days; secondary endpoints: major hemorrhage, ICH, and all-cause mortality.
- After matching, 963 patients per group showed similar ischemic stroke rates (1.3% vs 1.3%).
- Major hemorrhage and ICH rates were numerically higher for ticagrelor but not statistically significant.
- All-cause mortality was significantly higher in the ticagrelor group (1.7% vs 0.6%, p=0.025).
- Conclusion: Ticagrelor and clopidogrel are equivalent for ischemic stroke and hemorrhage risks, but ticagrelor has higher mortality risk.