Matsubara Hirofumi, Mizutani Daisuke, Egashira Yusuke, Enomoto Yukiko
Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Gifu, Japan.
J Neuroendovasc Ther. 2023;17(2):56-60. doi: 10.5797/jnet.oa.2022-0053. Epub 2023 Jan 11.
This study aimed to determine the status of perioperative antiplatelet therapy in stent-assisted coil embolization (SAC) in Japan.
The questionnaire consisted of 13 questions and used Google forms, and was sent to institutions where endovascular specialists were employed. The results were analyzed.
The responses from 307 centers indicated that the timing of initiation of antiplatelet therapy was 14 days-1 month before treatment in half of centers, and 7-14 days before treatment in the other half. Platelet function tests were performed at 165 centers (56.2%), of which 136 centers (46.3%) performed these tests for all patients, with the VerifyNow system being the most widely used tool. The duration of postoperative dual antiplatelet therapy was 6, 3, and 12 months in 169 (57.7%), 70 (23.5%), and 42 (14.3%) centers, respectively. The antiplatelet agents used for monotherapy were P2Y12 receptor antagonists or aspirin, with a postoperative period of up to 12 months in 139 centers (47.3%), 24 months in 68 centers (23.1%), and longer than 24 months in 50 centers (17%).
Current antiplatelet therapy for SAC in Japan varies widely among institutions. Moreover, each center has its own empirical rules for SAC. Therefore, the findings of this survey suggest the need to establish guidelines for optimal periprocedural antiplatelet therapy for SAC.
本研究旨在确定日本支架辅助弹簧圈栓塞术(SAC)围手术期抗血小板治疗的现状。
问卷由13个问题组成,通过谷歌表单发送至聘用血管内介入专家的机构,并对结果进行分析。
来自307个中心的回复表明,一半中心在治疗前14天至1个月开始抗血小板治疗,另一半在治疗前7至14天开始。165个中心(56.2%)进行了血小板功能检测,其中136个中心(46.3%)对所有患者进行了检测,VerifyNow系统是使用最广泛的工具。术后双联抗血小板治疗持续时间分别为6个月、3个月和12个月的中心有169个(57.7%)、70个(23.5%)和42个(14.3%)。单药治疗使用的抗血小板药物为P2Y12受体拮抗剂或阿司匹林,术后使用时间长达12个月的中心有139个(47.3%),24个月的有68个(23.1%),超过24个月的有50个(17%)。
目前日本SAC的抗血小板治疗在各机构之间差异很大。此外,每个中心对于SAC都有自己的经验性规则。因此,本次调查结果表明有必要制定SAC围手术期最佳抗血小板治疗指南。