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The potentially life-threatening consequences of a postoperative hemorrhagic complication after neurosurgical operative procedures are well known. In the present study, we evaluate the risk of continued ASA use as it relates to postoperative hemorrhage and cardiopulmonary complications in patients undergoing cerebral aneurysm surgery. We retrospectively analyzed 200 consecutive clipping procedures performed between 2008 and 2018. Two different statistical models were applied. The first model consisted of two groups: (1) group with <jats:italic>No ASA impact<\/jats:italic> - patients who either did not use ASA at all as well as those who had stopped their use of the ASA medication in time (&gt;\u2009=\u20097\u00a0days prior to operation); (2) group with <jats:italic>ASA impact<\/jats:italic> - all patients whose ASA use was not stopped in time. The second model consisted of three groups: (1) <jats:italic>No ASA use<\/jats:italic>; (2) <jats:italic>Stopped ASA use<\/jats:italic> (&gt;\u2009=\u20097\u00a0days prior to operation); (3) <jats:italic>Continued ASA use<\/jats:italic> (did not stop or did not stop in time, &lt;7\u00a0days prior to operation). Data collection included demographic information, surgical parameters, aneurysm characteristics, and all hemorrhagic\/thromboembolic complications. A postoperative hemorrhage was defined as relevant if a consecutive operation for hematoma removal was necessary. An ASA effect has been assumed in 32 out of 200 performed operations. A postoperative hemorrhage occurred in one out these 32 patients (3.1%). A postoperative hemorrhage in patients without ASA impact was detected and treated in 5 out of 168 patients (3.0%). The difference was statistically not significant in either model (<jats:italic>ASA impact group<\/jats:italic> vs. <jats:italic>No ASA impact group<\/jats:italic>: OR\u2009=\u20091.0516 [0.1187; 9.3132], <jats:italic>p<\/jats:italic>\u2009=\u20091.000; RR\u2009=\u20091.0015 [0.9360; 1.0716]). Cardiopulmonary complications were significantly more frequent in the group with ASA impact than in the group without ASA impact (<jats:italic>p<\/jats:italic>\u2009=\u20090.030). In this study continued ASA use was not associated with an increased risk of a postoperative hemorrhage. However, cardiopulmonary complications were significantly more frequent in the <jats:italic>ASA impact<\/jats:italic> group than in the <jats:italic>No ASA impact<\/jats:italic> group. Thus, ASA might relatively safely be continued in patients with increased cardiovascular risk and cases of emergency cerebrovascular surgery.<\/jats:p>","DOI":"10.1007\/s10143-021-01476-7","type":"journal-article","created":{"date-parts":[[2021,1,25]],"date-time":"2021-01-25T17:05:31Z","timestamp":1611594331000},"page":"2889-2898","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of acetylsalicylic acid in patients undergoing cerebral aneurysm surgery \u2013 should the neurosurgeon really worry about it?"],"prefix":"10.1007","volume":"44","author":[{"given":"Ali","family":"Rashidi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nadine","family":"Lilla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Skalej","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I. 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The collection, analysis and publication of retrospective clinical data is generally approved by the ethics committee of the Medical Faculty of the Otto-von-Guericke University of Magdeburg. The study was approved and registered by the institutional review board (IRB) of the Medical Faculty of the Otto-von-Guericke University of Magdeburg (Register#: R0320). Necessity for patient\u2019s informed consent was waived by the IRB.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The Author transfers to Springer (respective to owner if other than Springer and for U.S. government employees: to the extent transferable) the non-exclusive publication rights and he warrants that his\/her contribution is original and that he\/she has full power to make this grant. The author signs for and accepts responsibility for releasing this material on behalf of any and all co-authors. This transfer of publication rights covers the non-exclusive right to reproduce and distribute the article, including reprints, translations, photographic reproductions, microform, electronic form (offline, online) or any other reproductions of similar nature.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}}]}}