Low risk of intracranial and systemic hemorrhages in patients on dual antiplatelet treatment beyond 1 month following neuroendovascular angioplasty and/or stent placement

J Neuroimaging. 2012 Jan;22(1):67-73. doi: 10.1111/j.1552-6569.2010.00520.x. Epub 2010 Oct 26.


Background: Aspirin and clopidogrel treatment beyond 1 month in patients undergoing angioplasty and/or stent placement within the extra- and/or intracranial arteries is not defined.

Objective: To determine the incidence of intracranial and systemic bleeding events, recurrent ischemic stroke, and death in patients treated with dual antiplatelets for greater than 1 month.

Methods: We determined rates of hemorrhage, stroke, or death in consecutive patients with extra- or intracranial lesions, treated with dual antiplatelets after angioplasty and/or stent procedures.

Results: Dual antiplatelet treatment was initiated in 110 patients following endovascular treatment with a median treatment time period of 3 months (364 person-months of exposure). There were two bleeding events (1 intracranial and 1 gastrointestinal), 1 ischemic stroke, and no deaths. The rate of intracranial and systemic bleeding events, recurrent ischemic stroke, death due to stroke, or premature discontinuation was 8.3 per 1,000 person-months (95%, CI [2.7-25.6]). There were no bleeding events after the first month of treatment.

Conclusion: We did not find an increased risk of adverse events in patients treated with dual antiplatelet treatment beyond 1 month after endovascular procedure, supporting the safety of intermediate-term treatment as adjunct to intra- and extracranial angioplasty and/or stent placement.

MeSH terms

  • Angioplasty / mortality*
  • Aspirin / therapeutic use*
  • Blood Vessel Prosthesis / statistics & numerical data*
  • Clopidogrel
  • Combined Modality Therapy / mortality
  • Comorbidity
  • Drug Therapy, Combination / mortality
  • Drug-Related Side Effects and Adverse Reactions / mortality*
  • Female
  • Humans
  • Intracranial Hemorrhages / diagnostic imaging
  • Intracranial Hemorrhages / mortality*
  • Male
  • Middle Aged
  • Minnesota / epidemiology
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prevalence
  • Radiography
  • Risk Assessment
  • Risk Factors
  • Stents / statistics & numerical data*
  • Survival Analysis
  • Survival Rate
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / therapeutic use
  • Treatment Outcome


  • Platelet Aggregation Inhibitors
  • Clopidogrel
  • Ticlopidine
  • Aspirin