Effects of Antiplatelet Agents on Cerebral Vasospasm and Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage Patients Treated with Coil Embolization

Objective: This study aimed to investigate the role of antiplatelet agents (APAs) in preventing cerebral vasospasm (CVS) and delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (SAH) patients treated with coil embolization. Methods: We reviewced data from 131 consecutive patients who underwent coil embolization following aneurysmal SAH from January 2011 to May 2021. We finally recruited 108 patients and analyzed the occurrence of CVS and DCI, as well as the modified Rankin Scale (mRS) score at discharge according to the use of APA (APA group [n=32] vs. non-APA group [n=76]). Results: The baseline characteristics, except patient age, were not significantly different between the APA and the non-APA groups. DCI (p=0.846), transcranial Doppler ultrasonographic vasospasm (p=0.449), angiographic vasospasm (p=0.176), and mRS scores at discharge (p=0.194) were also not significantly different between the groups. Newly developed cerebral infarction was significantly more frequent in the APA group (p=0.027). Conclusion: APA use did not reduce the occurrence of CVS and DCI in aneurysmal SAH patients treated with coil embolization, indicating that the effect of APAs on clinical outcomes may be trivial compared with other risk factors.