{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:57:31Z","timestamp":1787756251119,"version":"build-2784847793"},"reference-count":28,"publisher":"BMJ","issue":"11","funder":[{"DOI":"10.13039\/501100003670","name":"National Evidence-based Healthcare Collaborating Agency","doi-asserted-by":"publisher","award":["NA19-003\/NA20-004"],"award-info":[{"award-number":["NA19-003\/NA20-004"]}],"id":[{"id":"10.13039\/501100003670","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2022,12,19]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Antiplatelet therapy, where regimens are tailored based on platelet function testing, has been introduced into neurointerventional surgery. This nationwide registry study evaluated the effect and safety of tailored antiplatelet therapy in stent assisted coiling for unruptured aneurysms compared with conventional therapy using a standard regimen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study enrolled 1686 patients in 44 participating centers who received stent assisted coiling for unruptured aneurysms between January 1, 2019 and December 31, 2019. The standard regimen (aspirin and clopidogrel) was used for all patients in the conventional group (924, 19 centers). The regimen was selected based on platelet function testing (standard regimen for clopidogrel responders; adding cilostazol or replacing clopidogrel with other thienopyridines (ticlopidine, prasugrel, or ticagrelor) for clopidogrel non-responders) in the tailored group (762, 25 centers). The primary outcome was thromboembolic events. Secondary outcomes were bleeding and poor outcomes (increase in modified Rankin Scale score). Outcomes within 30 days after coiling were compared using logistic regression analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The thromboembolic event rate was lower in the tailored group than in the conventional group (30\/762 (3.9%) vs 63\/924 (6.8%), adjusted OR 0.560, 95% CI 0.359 to 0.875, P=0.001). The bleeding event rate was not different between the study groups (62\/762 (8.1%) vs 73\/924 (7.9%), adjusted OR 0.790, 95%\u2009CI 0.469 to 1.331, P=0.376). Poor outcomes were less frequent in the tailored group (12\/762 (1.6%) vs 34 (3.7%), adjusted OR 0.252, 95%\u2009CI 0.112 to 0.568, P=0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tailored antiplatelet therapy in stent assisted coiling for unruptured aneurysms reduced thromboembolic events and poor outcomes without increasing bleeding.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnis-2022-019571","type":"journal-article","created":{"date-parts":[[2023,1,3]],"date-time":"2023-01-03T18:47:39Z","timestamp":1672771659000},"page":"1095-1104","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Tailored antiplatelet therapy in stent assisted coiling for unruptured aneurysms: a nationwide registry study"],"prefix":"10.1136","volume":"15","author":[{"given":"Jun Seok","family":"Koh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7405-0487","authenticated-orcid":false,"given":"Gyojun","family":"Hwang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Cheol","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2745-446X","authenticated-orcid":false,"given":"Joonho","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Weon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyon-Jo","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong-Rim","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Hun","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon Chan","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Tae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chul Hoon","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong-Kyu","family":"Jang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hyung","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Woo","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bum-Tae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byoung Gook","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1056-7479","authenticated-orcid":false,"given":"Seung Hoon","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Young","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junkyeung","family":"Ko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Gon","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seok-Mann","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Young","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Hyun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Hoon","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae-Won","family":"Koo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Hoon","family":"Sung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinnie","family":"Rhee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Gyun","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,3]]},"reference":[{"key":"2024052220085274000_15.11.1095.1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7303"},{"key":"2024052220085274000_15.11.1095.2","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2018.0151"},{"key":"2024052220085274000_15.11.1095.3","doi-asserted-by":"crossref","first-page":"E52","DOI":"10.1093\/neuros\/nyy341","article-title":"Low-dose prasugrel vs clopidogrel-based tailored premedication for endovascular treatment of cerebral aneurysms","volume":"85","author":"Cho","year":"2019","journal-title":"Neurosurgery"},{"key":"2024052220085274000_15.11.1095.4","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2020-016994"},{"key":"2024052220085274000_15.11.1095.5","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1001\/jamaneurol.2015.0654","article-title":"Standard vs modified antiplatelet preparation for preventing thromboembolic events in patients with high on-treatment platelet reactivity undergoing coil embolization for an unruptured intracranial aneurysm: a randomized clinical trial","volume":"72","author":"Hwang","year":"2015","journal-title":"JAMA Neurol"},{"key":"2024052220085274000_15.11.1095.6","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2016160542"},{"key":"2024052220085274000_15.11.1095.7","doi-asserted-by":"publisher","DOI":"10.5469\/neuroint.2018.01088"},{"key":"2024052220085274000_15.11.1095.8","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7216"},{"key":"2024052220085274000_15.11.1095.9","doi-asserted-by":"publisher","DOI":"10.1177\/1591019916669090"},{"key":"2024052220085274000_15.11.1095.10","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1177\/0897190019854868","article-title":"Neuro-interventional use of oral antiplatelets: a survey of neuro-endovascular centers in the United States and review of the literature","volume":"34","author":"Farrokh","year":"2021","journal-title":"J Pharm Pract"},{"key":"2024052220085274000_15.11.1095.11","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1055\/s-0035-1570083","article-title":"Platelet function testing in patients on antiplatelet medications","volume":"42","author":"Gross","year":"2016","journal-title":"Semin Thromb Hemost"},{"key":"2024052220085274000_15.11.1095.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.101"},{"key":"2024052220085274000_15.11.1095.13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"2024052220085274000_15.11.1095.14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.2176\/nmc.st.2019-0210","article-title":"Coil embolization for unruptured intracranial aneurysms at the dawn of stent era: results of the Japanese Registry of Neuroendovascular Therapy (JR-NET) 3","volume":"60","author":"Satow","year":"2020","journal-title":"Neurol Med Chir"},{"key":"2024052220085274000_15.11.1095.15","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4864"},{"key":"2024052220085274000_15.11.1095.16","doi-asserted-by":"crossref","first-page":"539","DOI":"10.3340\/jkns.2019.0082","article-title":"The efficacy of P2Y12 reactive unit to predict the periprocedural thromboembolic and hemorrhagic complications according to clopidogrel responsiveness and safety of modification of dual antiplatelet therapy: a meta-analysis","volume":"63","author":"Kim","year":"2020","journal-title":"J Korean Neurosurg Soc"},{"key":"2024052220085274000_15.11.1095.17","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.046786"},{"key":"2024052220085274000_15.11.1095.18","doi-asserted-by":"crossref","DOI":"10.3390\/jcm9103249","article-title":"Ticagrelor versus clopidogrel in older patients with NSTE-ACS using oral anticoagulation: a sub-analysis of the popular age trial","volume":"9","author":"Gimbel","year":"2020","journal-title":"J Clin Med"},{"key":"2024052220085274000_15.11.1095.19","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-15-0112"},{"key":"2024052220085274000_15.11.1095.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.008"},{"key":"2024052220085274000_15.11.1095.21","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041766"},{"key":"2024052220085274000_15.11.1095.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205512"},{"key":"2024052220085274000_15.11.1095.23","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-13-1482"},{"key":"2024052220085274000_15.11.1095.24","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032180"},{"key":"2024052220085274000_15.11.1095.25","article-title":"Ticagrelor or prasugrel in acute coronary syndromes","volume":"382","author":"Sch\u00fcpke","year":"2020","journal-title":"N Engl J Med"},{"key":"2024052220085274000_15.11.1095.26","doi-asserted-by":"publisher","DOI":"10.1097\/FJC.0000000000000390"},{"key":"2024052220085274000_15.11.1095.27","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"2024052220085274000_15.11.1095.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61451-8"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnis-2022-019571","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T03:15:10Z","timestamp":1716434110000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/jnis-2022-019571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,3]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,10,12]]},"published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1136\/jnis-2022-019571"],"URL":"https:\/\/doi.org\/10.1136\/jnis-2022-019571","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,3]]}}}