Introduction Stent-assisted coil embolisation (SACE) for the treatment of unruptured cerebral aneurysms has been increasingly used. Long-term advantages of antiplatelet therapy (APT) post-SACE treatment are still not well understood. We investigated the long-term effects of APT on clinical prognosis after SACE. Patients and methods We conducted a retrospective study using nationwide health insurance claims data from South Korea, including patients with cerebral aneurysm treated with SACE from January 2009 to December 2020. The study outcomes consisted of the occurrence of cerebral infarction and major haemorrhage. To evaluate the impact of APT, we employed a multivariable time-dependent Cox proportional hazards regression model for each of the three distinct periods: 1–12 months, 12–24 months and >24 months after SACE. Results This study included 17 692 unruptured cerebral aneurysm patients treated with SACE. During the mean follow-up of 4.2 years, there were 379 (2.1%) patients with cerebral infarction and 190 (1.1%) patients with major haemorrhage. The percentage of patients receiving APT was 79.5% at 1 year, which gradually decreased to 58.3% at 2 years after SACE. APT was beneficial in preventing cerebral infarction within 12 months after SACE (adjusted HR (aHR) 0.56; 95% CI, 0.35 to 0.89; p=0.014). After 12 months, this association was not evident. APT increased the risk of haemorrhage after 24 months (aHR 1.76; 95% CI 1.11 to 2.87; p=0.016). Discussion and conclusion Our findings suggest that in patients with unruptured cerebral aneurysm treated with SACE, the reasonable duration of APT for preventing cerebral infarction might be 1 year after SACE. Data are available upon reasonable request. The data supporting the findings of this study are available from the Health Insurance Review and Assessment Service (HIRA) database. Researchers can gain access by submitting a request with the HIRA Big Data Hub ([https://opendata.hira.or.kr][1]) [1]: https://opendata.hira.or.kr/home.do

中文翻译：

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脑动脉瘤支架辅助弹簧圈栓塞术后停止抗血小板治疗：一项全国性队列研究

简介 用于治疗未破裂脑动脉瘤的支架辅助弹簧圈栓塞术 (SACE) 已被越来越多地使用。SACE 治疗后抗血小板治疗 (APT) 的长期优势仍不清楚。我们研究了 APT 对 SACE 后临床预后的长期影响。患者和方法我们利用韩国全国健康保险理赔数据进行了一项回顾性研究，包括2009年1月至2020年12月接受SACE治疗的脑动脉瘤患者。研究结果包括脑梗塞和大出血的发生情况。为了评估 APT 的影响，我们针对 SACE 后 1-12 个月、12-24 个月和 >24 个月这三个不同时期的每个时期采用了多变量时间依赖性 Cox 比例风险回归模型。结果 本研究纳入了 17 692 名接受 SACE 治疗的未破裂脑动脉瘤患者。在平均4.2年的随访期间，有379名（2.1%）名脑梗塞患者和190名（1.1%）名大出血患者。1年时接受APT的患者比例为79.5%，SACE后2年逐渐下降至58.3%。APT 在 SACE 后 12 个月内有利于预防脑梗塞（调整后 HR (aHR) 0.56；95% CI，0.35 至 0.89；p=0.014）。12 个月后，这种关联不再明显。APT 增加 24 个月后出血风险（aHR 1.76；95% CI 1.11 至 2.87；p=0.016）。讨论和结论我们的研究结果表明，在接受SACE治疗的未破裂脑动脉瘤患者中，预防脑梗死的APT合理持续时间可能是SACE后1年。数据可根据合理要求提供。支持本研究结果的数据可从健康保险审查和评估服务 (HIRA) 数据库中获取。研究人员可以通过向 HIRA 大数据中心 ([https://opendata.hira.or.kr][1]) [1] 提交请求来获得访问权限：https://opendata.hira.or.kr/home。做