ReviewClinical neuroradiology2026
Comparative Safety and Efficacy of Dual Antiplatelet Therapy Regimens in Flow Diversion for Intracranial Aneurysms: a Systematic Review and Network Meta-Analysis.
Review in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDual antiplatelet therapy is required after flow-diverter treatment of intracranial aneurysms, but the comparative safety and efficacy of clopidogrel-, ticagrelor-, and prasugrel-based regimens remain uncertain. Therefore, the purpose of this study was to compare ischemic, hemorrhagic, functional, and mortality outcomes among different P2Y12 inhibitor-based dual antiplatelet therapy regimens after flow diversion for intracranial aneurysms.
methodsA systematic review and frequentist random-effects network meta-analysis were performed according to PRISMA guidelines. PubMed, Embase, and CENTRAL were searched from inception through February 2026. Eligible studies included randomized and nonrandomized comparative studies evaluating clopidogrel-, ticagrelor-, or prasugrel-based dual antiplatelet therapy after flow-diverter treatment. Outcomes were expressed as odds ratios with 95% confidence intervals relative to clopidogrel. Heterogeneity, consistency, treatment ranking by P‑scores, risk of bias, publication bias, and certainty of evidence were assessed.
resultsEleven studies including 2267 patients, at least 2285 procedures, and 2502 aneurysms were included. Compared with clopidogrel-based therapy, ticagrelor- and prasugrel-based regimens showed no statistically significant differences in early ischemic or hemorrhagic complications, ischemic or hemorrhagic complications at longest follow-up, or mortality. Ticagrelor was associated with lower odds of a good functional outcome compared with clopidogrel. Prasugrel ranked highest for ischemic outcomes at longest follow-up, hemorrhagic outcomes at longest follow-up, and good functional outcome. Certainty of evidence was low or very low.
conclusionsCurrent FD-specific evidence is insufficient to establish superiority, inferiority, or equivalence among clopidogrel-, ticagrelor-, and prasugrel-based DAPT regimens across ischemic, hemorrhagic, functional, and survival outcomes. Because treatment allocation was non-random and alternative regimens were preferentially used in patients with suspected clopidogrel hyporesponsiveness, these findings should not be read as supporting a clopidogrel-first hierarchy; regimen selection is likely to remain guided by local pharmacogenetic testing, and cost considerations pending higher-quality comparative data.
Indexed as
Identifiers
42711420What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.