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The following is a summary of “Delayed ischemic stroke after PED placement for aneurysms: optimal duration of dual antiplatelet therapy and risk factors,” published in the April 2025 issue of Frontiers in Neurology by Wang et al. 

Delayed ischemic stroke (DIS) is a rare complication after pipeline embolization device (PED) treatment for cerebral aneurysms 

Researchers conducted a retrospective study to assess DIS after PED placement and evaluate the optimal duration of dual antiplatelet therapy (DAPT). 

They conducted a multicenter retrospective cohort study on intracranial aneurysms treated with PED, dividing patients into early (<6 months) and late (≥6 months) DAPT groups. They used inverse probability of treatment weighting (IPTW), Kaplan–Meier analysis, and multivariate Cox regression to calculate DIS rates and risk factors. 

The results showed that 12 of 1,146 patients (0.96%) who received PED developed DIS, despite a total of 1,296 aneurysms being treated. The late-switch group had a lower DIS rate than the early-switch group [0.5% (4/752) vs. 2.0% (8/394), P = 0.018]. Hypertension [hazard ratio (HR) 3.47, 95% CI: 1.045–11.552] and immediate complete occlusion (HR 5.48, 95% CI: 3.048–9.868) were significant risk factors. 

Investigators found that DIS was a rare complication in patients treated with PED. They observed that extending DAPT to at least 6 months was safer for patients with hypertension and immediate complete occlusion. 

Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2025.1561965/full