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| Application of Different Perioperative Antiplatelet Regimens in Patients with Unruptured Intracranial Aneurysms Treated by Interventional Therapy and Comparison of the Risks of Bleeding after Operation |
| ZHOU Jing-bin, WANG Mu-chun, DENG Dong-feng |
| Zhongshan Hospital, Affiliated to Dalian University, Dalian, Liaoning 116001, China |
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Abstract 【Objective】To investigate the application of different perioperative antiplatelet regimens in patients with unruptured intracranial aneurysms treated by interventional therapy and compare the risks of bleeding.【Methods】A total of 160 cases of patients with unruptured intracranial aneurysms treated by interventional therapy in our hospital from February 2012 to October 2016 were enrolled in the study. According to the different treatment methods, the patients were divided into A group [treated with loading dose (8μg/kg) of tirofiban for 3 min, followed by the maintenance dose (0.1μg/kg·min), n=50], B group (treated with loading dose of clopidogrel at 2h~24h before operation, n=60) and C group (treated with 75mg of clopidogrel and 100mg of Bayaspirin at 3~5d before operation, n=50). We observed the incidence of bleeding and thromboembolic events, the occurrence of complications, changes of Glasgow Coma Scale (GOS) scores, and follow-up results.【Results】After operation, the incidence rates of bleeding events, thromboembolic events and complications were significantly lower in A group than B group and C group. The prognosis of A group was significantly better than that of B group and C group (P<0.05). However, there were no statistically significant differences between B group and C group in the incidence rates of bleeding events, thromboembolic events and complications and the prognosis (P>0.05). There were no significant differences in GOS scores among the three groups before treatment (P>0.05). At 1 month, 2 months and 3 months after operation, the GOS scores of the three groups were significantly higher, and the increase was more obvious in A group than B group and C group (P<0.05). However, there was no significant difference between B group and C group (P>0.05). The follow-up rate was 100% (50/50) in group A, 98.33 (59/60) in group B, and 96.00 (48/50) in group C. The follow-up results showed that the prognosis of group A was significantly better than group B and group C ; the difference was statistically significant (P<0.05).【Conclusion】Tirofiban regimen can be used as a safe and effective antiplatelet treatment for patients with unruptured intracranial aneurysms treated by interventional therapy. Compared with dual antiplatelet regimen and loading dose of clopidogrel regimen, it has more advantages, and the risks of bleeding are lower.
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Received: 01 September 2017
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2018, Vol. 35 
