TY  - BOOK
AU  - Armonda, Rocco A
AU  - Chang, Jason J
AU  - Dowlati, Ehsan
AU  - Liu, Ai-Hsi
AU  - Mai, Jeffrey C
AU  - Sur, Samir
TI  - Treatment of In-Stent Stenosis Following Flow Diversion of Intracranial Aneurysms with Cilostazol and Clopidogrel
SN  - 2093-9043
PY  - 2021///
KW  - IN PROCESS -- NOT YET INDEXED
KW  - MedStar Washington Hospital Center
KW  - Neurosurgery
KW  - Neurosurgery Residency
KW  - Radiology
KW  - Surgery/Surgical Critical Care
KW  - Case Reports
N2  - In-stent stenosis is a feared complication of flow diversion treatment for cerebral aneurysms. We present 2 cases of patients treated with pipeline flow diversion for unruptured cerebral aneurysms. Initial perioperative dual antiplatelet therapy (DAPT) consisted of standard aspirin plus clopidogrel. At 6-month follow-up cerebral angiography, the patients were noted to have developed significant in-stent stenosis (63% and 53%). The patients were treated with cilostazol and clopidogrel for at least 6 months. Subsequent angiography at 1-year post-treatment showed significant improvement of the in-stent stenosis from 63% to 34% and 53% to 21%. The role of cilostazol as treatment of intracranial in-stent stenosis has not been previously described. Cilostazol's vasodilatory effect and suppression of vascular smooth muscle proliferation provides ideal benefits in this setting. Cilostazol plus clopidogrel may be a safe and effective alternative to standard DAPT for treatment of in-stent stenosis following flow diversion and warrants further consideration and investigation
UR  - https://dx.doi.org/10.5469/neuroint.2021.00290
ER  -