Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms
BackgroundPerioperative cerebrovascular thromboembolic events are serious complications of stent-assisted embolization (SAE) for unruptured intracranial aneurysms (UIAs). To date, there have been no definitive clinical trial results to effectively predict and prevent the occurrence of this complicat...
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Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1538753/full |
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| author | Xiaopeng Huang Tingbao Zhang Yu Feng Xiang Li Xiang Li Xiang Li Xiang Li Xiang Li Kui Liu Wenyuan Zhao |
| author_facet | Xiaopeng Huang Tingbao Zhang Yu Feng Xiang Li Xiang Li Xiang Li Xiang Li Xiang Li Kui Liu Wenyuan Zhao |
| author_sort | Xiaopeng Huang |
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| description | BackgroundPerioperative cerebrovascular thromboembolic events are serious complications of stent-assisted embolization (SAE) for unruptured intracranial aneurysms (UIAs). To date, there have been no definitive clinical trial results to effectively predict and prevent the occurrence of this complication. This study aims to elucidate the correlation between platelet aggregation rate (PAR) and thromboembolic events (TEs), with the goal of predicting the occurrence of cerebrovascular TEs in these patients.MethodsIn this retrospective, single-center cohort study, we included 704 cases of unruptured intracranial aneurysms treated with stent-assisted intervention from 2016 to 2020. Cerebrovascular TEs were defined as cerebral ischemic events occurring within 7 days before or after the interventional procedure. Light Transmission Aggregometry (LTA) was used to detect PAR in patients. Clinical data, including patients’ demographic information and perioperative PAR, were collected. Multivariate analysis was conducted to examine the correlation between these factors and the occurrence of TEs. Additionally, Lasso regression was employed to select clinical indicators associated with perioperative TEs. Receiver Operating Characteristic (ROC) curves were generated for prognostic indicators such as PAR, with the optimal cutoff value determined. A nomogram was then simulated, and predictive accuracy of the model was evaluated using Decision Curve Analysis (DCA).ResultsA total of 562 patients were included in the final analysis. Significant differences were observed in the incidence of thrombosis between the control group and the experimental group (9.38% vs. 4.96%). The ROC curve of platelet aggregation index, highly correlated with prognosis and derived from Lasso regression, identified the optimal cutoff value for the maximum preoperative PAR as 19.81. A nomogram was constructed based on selected clinical baseline data, and its calibration was assessed using data from the prediction group. The net benefit of the experimental group model’s DCA curve was significantly improved.ConclusionFor patients undergoing SAE for UIAs, utilizing PAR and other indicators as reference standards for treatment results in better prognosis compared to empirical treatment based on guidelines. Guiding antiplatelet therapy using PAR and other indicators is both meaningful and beneficial to clinical practice. |
| format | Article |
| id | doaj-art-665286cd4bcd48ccbf026cff0434a86d |
| institution | OA Journals |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-665286cd4bcd48ccbf026cff0434a86d2025-08-20T02:19:47ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-05-011610.3389/fneur.2025.15387531538753Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysmsXiaopeng Huang0Tingbao Zhang1Yu Feng2Xiang Li3Xiang Li4Xiang Li5Xiang Li6Xiang Li7Kui Liu8Wenyuan Zhao9Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaBrain Research Center, Zhongnan Hospital of Wuhan University, Wuhan, ChinaFrontier Science Center for Immunology and Metabolism, Wuhan University, Wuhan, ChinaMedical Research Institute, Wuhan University, Wuhan, ChinaSino-Italian Ascula Brain Science Joint Laboratory, Wuhan University, Wuhan, ChinaDepartment of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaDepartment of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, ChinaBackgroundPerioperative cerebrovascular thromboembolic events are serious complications of stent-assisted embolization (SAE) for unruptured intracranial aneurysms (UIAs). To date, there have been no definitive clinical trial results to effectively predict and prevent the occurrence of this complication. This study aims to elucidate the correlation between platelet aggregation rate (PAR) and thromboembolic events (TEs), with the goal of predicting the occurrence of cerebrovascular TEs in these patients.MethodsIn this retrospective, single-center cohort study, we included 704 cases of unruptured intracranial aneurysms treated with stent-assisted intervention from 2016 to 2020. Cerebrovascular TEs were defined as cerebral ischemic events occurring within 7 days before or after the interventional procedure. Light Transmission Aggregometry (LTA) was used to detect PAR in patients. Clinical data, including patients’ demographic information and perioperative PAR, were collected. Multivariate analysis was conducted to examine the correlation between these factors and the occurrence of TEs. Additionally, Lasso regression was employed to select clinical indicators associated with perioperative TEs. Receiver Operating Characteristic (ROC) curves were generated for prognostic indicators such as PAR, with the optimal cutoff value determined. A nomogram was then simulated, and predictive accuracy of the model was evaluated using Decision Curve Analysis (DCA).ResultsA total of 562 patients were included in the final analysis. Significant differences were observed in the incidence of thrombosis between the control group and the experimental group (9.38% vs. 4.96%). The ROC curve of platelet aggregation index, highly correlated with prognosis and derived from Lasso regression, identified the optimal cutoff value for the maximum preoperative PAR as 19.81. A nomogram was constructed based on selected clinical baseline data, and its calibration was assessed using data from the prediction group. The net benefit of the experimental group model’s DCA curve was significantly improved.ConclusionFor patients undergoing SAE for UIAs, utilizing PAR and other indicators as reference standards for treatment results in better prognosis compared to empirical treatment based on guidelines. Guiding antiplatelet therapy using PAR and other indicators is both meaningful and beneficial to clinical practice.https://www.frontiersin.org/articles/10.3389/fneur.2025.1538753/fullplatelet aggregation ratestent-assisted embolizationunruptured intracranial aneurysmsthromboembolic eventsantiplatelet therapy |
| spellingShingle | Xiaopeng Huang Tingbao Zhang Yu Feng Xiang Li Xiang Li Xiang Li Xiang Li Xiang Li Kui Liu Wenyuan Zhao Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms Frontiers in Neurology platelet aggregation rate stent-assisted embolization unruptured intracranial aneurysms thromboembolic events antiplatelet therapy |
| title | Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms |
| title_full | Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms |
| title_fullStr | Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms |
| title_full_unstemmed | Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms |
| title_short | Platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent-assisted embolization for unruptured arterial aneurysms |
| title_sort | platelet aggregation rate serves as a significant predictive indicator for thromboembolic events in the context of stent assisted embolization for unruptured arterial aneurysms |
| topic | platelet aggregation rate stent-assisted embolization unruptured intracranial aneurysms thromboembolic events antiplatelet therapy |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1538753/full |
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