Key result
Pre-procedural dual antiplatelet therapy significantly reduced the 30-day rate of stroke to 0.8% compared to 7.1% with aspirin alone and 6.9% with clopidogrel alone in patients undergoing carotid artery stenting.
Why the study?
Effective antiplatelet therapy is vital for enhancing the success and safety of CAS, but determining the best pre-stenting approach remains a priority.
Does pre-procedural dual antiplatelet therapy reduce stroke, TIA, and bleeding complications compared to aspirin or clopidogrel monotherapy in patients undergoing carotid artery stenting?
Cohort (n=235)
No
Does pre-procedural dual antiplatelet therapy reduce stroke, TIA, and bleeding complications compared to aspirin or clopidogrel monotherapy in patients undergoing carotid artery stenting?
Absolute Event Rate: 0.8% vs 7.1%
p-value: p=0.047
Pre-procedural dual antiplatelet therapy significantly reduces short-term stroke and TIA compared to aspirin or clopidogrel monotherapy in patients undergoing carotid artery stenting.
Objective: This study investigates the influence of various antiplatelet regimens before carotid artery stenting (CAS) on short-term and long-term clinical outcomes. Effective antiplatelet therapy is vital for enhancing the success and safety of CAS. Determining the best approach remains a priority. Methods: This retrospective cohort analysis involved 235 patients who underwent CAS at a single institution between October 2020 and October 2024. Participants were divided into three groups based on the antiplatelet regimen administered before the procedure: dual antiplatelet therapy (DAPT), aspirin monotherapy (SAPT-A), and clopidogrel monotherapy (SAPT-C). The main outcomes evaluated were stroke, transient ischemic attack (TIA), and bleeding complications. Secondary outcomes included restenosis, stent thrombosis, and death. Statistical methods were applied to compare outcomes across the groups. Results: Stroke (0.8%) and TIA (2.5%) were notably less frequent in the DAPT group compared to the SAPT-A (7.1% and 12.5%, respectively) and SAPT-C (6.9% and 8.6%, respectively) groups (P<0.05). Rates of stent thrombosis (1.7%-1.8%) and mortality (0.8%-3.4%) at six months showed no significant differences among the groups (P>0.05). Conclusions: Pre-procedural DAPT reduces short-term ischemic complications in CAS. However, long-term outcomes were comparable across regimens. These findings suggest that antiplatelet strategies should be individualized. Larger studies with longer follow-ups are needed.
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Arslantürk et al. (2025) conducted a cohort in Carotid artery stenosis (n=235). Dual antiplatelet therapy (clopidogrel and aspirin) vs. Aspirin monotherapy or clopidogrel monotherapy was evaluated on 30-day stroke (p=0.047). Pre-procedural dual antiplatelet therapy significantly reduced the 30-day rate of stroke to 0.8% compared to 7.1% with aspirin alone and 6.9% with clopidogrel alone in patients undergoing carotid artery stenting.
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