{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T17:24:29Z","timestamp":1761845069023,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2019,8,19]]},"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background and purpose<\/jats:title>\n                  <jats:p>Thromboembolic events are recognized complications of aneurysm coiling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify any protective effects of antiplatelet therapy use before coiling of unruptured aneurysms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a meta-analysis of clinical studies published up to February 2019. We included studies reporting symptomatic thromboembolic events (defined as clinical stroke or transient ischemic attacks) in patients who received antiplatelet therapy before coiling of unruptured aneurysms using unassisted coiling, balloon assistance, or multiple microcatheters. We excluded ruptured aneurysms and those treated with stent coiling or flow diverters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We identified 14 studies (2486 patients). All were single-center studies and four were prospective. In three studies with a control (no treatment) arm, the pooled risk ratio for symptomatic thromboembolic events with versus without antiplatelet therapy was 0.33 (95% CI 0.17 to 0.92, p= 0.035). The cumulative risk of symptomatic thromboembolic events with single antiplatelet agents was 5.0% \u201856\/1122\u2019 (95%\u2009CI 1.6% to 8.4%, I<jats:sup>2<\/jats:sup>83.63%), and with dual or multiple agents 2.7% \u201833\/1237\u2019 (95%\u2009CI 1.0% to 3.0%, I<jats:sup>2<\/jats:sup>39.9%). The incidence of diffusion lesions was reported in seven studies. It was 50.5% \u201896\/190\u2019 (95%\u2009CI 7.3% to 93.9%, I<jats:sup>2<\/jats:sup>94.4%) with single agents compared with 43.9% \u2018196\/446\u2019 (95%\u2009CI 25.9% to 61.9%, I<jats:sup>2<\/jats:sup>73.4%) with dual or multiple agents.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Periprocedural antiplatelet therapy was associated with a low symptomatic thromboembolic event after coiling-only for unruptured aneurysms. However, available evidence is of limited quality with significant heterogeneity, requiring evidence from randomized controlled trials.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2019-015173","type":"journal-article","created":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T17:15:50Z","timestamp":1568999750000},"page":"298-302","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Antiplatelet therapy for prevention of thromboembolic complications in coiling-only procedures for unruptured brain aneurysms"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-8197","authenticated-orcid":false,"given":"Mohammed A","family":"Almekhlafi","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Calgary Stroke Program, and Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"},{"name":"Department of Radiology, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Community Health Sciences, and O\u2019Brien Institute for Public Health\u200b , University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2849-5386","authenticated-orcid":false,"given":"Abdulaziz S","family":"Al Sultan","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Calgary Stroke Program, and Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"},{"name":"Department of Community Health Sciences, and O\u2019Brien Institute for Public Health\u200b , University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M","family":"Kuczynski","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Calgary Stroke Program, and Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, and Radiology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bijoy K","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Calgary Stroke Program, and Hotchkiss Brain Institute, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada"},{"name":"Department of Radiology, University of Calgary, Calgary, Alberta, Canada"},{"name":"Department of Community Health Sciences, and O\u2019Brien Institute for Public Health\u200b , University of Calgary, Calgary, Alberta, 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