Trends in Dual Antiplatelet Therapy Use for Neurointerventional Procedures for the Management of Intracranial Aneurysms

The use of periprocedural dual antiplatelet therapy (DAPT) has significantly evolved along with innovations in the endovascular management intracranial aneurysms. Historically, aspirin and clopidogrel have been most commonly employed regimen due to its safety efficacy. However, recent studies highlight importance tailoring DAPT regimens individual patient characteristics which may affect metabolism, such as genetic polymorphisms. In present report, a systematic review literature was performed determine optimal flow diverting stents, intrasaccular devices, stent-assisted coiling. Studies were analyzed for number aneurysms treated, regimen, any thromboembolic complications. Based on inclusion criteria, 368 selected, revealed increasing popularity alternative aforementioned devices. Thromboembolic or hemorrhagic complications associated medications similar across all medications. ticagrelor, tirofiban, prasugrel are effective safe alternatives do not require enzymatic activation. Further clinical trials needed evaluate different various devices establish highest-level evidence-based guidelines recommendations.