{"id":"bf203669ae6c","type":"article","url":"https://hartvaat.nl/2026/12/01/antitrombotica-veilig-bij-incidentele-ongescheurde-intracraniele-aneurysmas-na-i/","title":"Antitrombotica veilig bij incidentele ongescheurde intracraniële aneurysma’s na ischemisch beroerte","title_en":"Impact of antithrombotic therapy on outcomes of incidental unruptured intracranial aneurysms in patients with ischemic stroke.","category":"preventie","category_label":"Preventie","professions":["cardioloog","huisarts","internist"],"tags":[],"journal":"Annals of medicine","doi":"10.1080/07853890.2026.2705593","source_url":"https://doi.org/10.1080/07853890.2026.2705593","authors":["Chao Chen","Yiya Xu","Yingchao He","Ting Chen","Xingyong Chen"],"significance":4,"published":"2026-08-19","source_date":"2026-12-01","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"A single-center retrospective cohort study evaluated whether standard antithrombotic regimens increase the risk of rupture in patients with ischemic stroke and concomitant incidental unruptured intracranial aneurysms. Among 197 patients followed for a mean of 28.6 months, only two experienced aneurysm rupture (1.0%), with no statistically significant difference between single antiplatelet therapy, anticoagulation, or no regular therapy. These findings suggest that standard secondary stroke prevention can be safely continued in this population, though the low event rate warrants cautious interpretation and individualized risk assessment.","created":"2026-08-13T00:47:22Z","updated":"2026-08-13T00:47:22Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In een retrospectieve cohortstudie onderzochten onderzoekers of secundaire preventie met antitrombotica het risico op rupture van incidentele, ongescheurde intracraniële aneurysma’s verhoogt bij patiënten met een ischemisch beroerte. Van de 197 patiënten liepen er slechts twee (1,0%) een rupture op, zonder significant verschil tussen patiënten op enkelvoudige antiplatelettherapie, anticoagulatie of geen reguliere therapie. Voor de klinische praktijk betekent dit dat standaard secundaire preventie na een ischemisch beroerte veilig kan worden voortgezet, mits de aneurysma’s klein en incidenteel zijn en individueel worden geëvalueerd.","abstract_original":"BACKGROUND: The coexistence of acute ischemic stroke (AIS) and unruptured intracranial aneurysms (UIAs) is relatively common, but the safety of antithrombotic therapy in this population remains uncertain. This study evaluated whether different secondary prevention regimens influence UIA progression or rupture risk. METHODS: This single-center retrospective cohort study included patients with AIS and concomitant saccular UIAs between January 2016 and December 2021. Patients were categorized according to long-term antithrombotic exposure: single antiplatelet therapy (SAPT), anticoagulation, or no regular therapy. Dual antiplatelet therapy (DAPT) was analyzed separately. The primary outcome was aneurysm rupture; secondary outcomes included symptomatic events and radiographic progression (≥1 mm growth). RESULTS: Among 197 patients (mean age 68.4 ± 10.2 years; 53.8% female), 140 received SAPT, 36 received anticoagulation, and 21 received no regular therapy. During a mean follow-up of 28.6 ± 18.4 months, aneurysm rupture occurred in two patients (1.0%). No ruptures occurred in the anticoagulation group. Firth's penalized logistic regression showed no significant association between antithrombotic regimen and aneurysm rupture (anticoagulation vs SAPT: OR 0.41, 95% CI 0.01-5.21; no therapy vs SAPT: OR 3.21, 95% CI 0.21-45.6; both p > 0.05). CONCLUSIONS: In patients with small incidental saccular UIAs and AIS, standard secondary prevention regimens were not associated with an increased risk of aneurysm rupture. However, the limited number of rupture events and potential residual confounding warrant cautious interpretation. Secondary stroke prevention should remain the priority, with individualized assessment of aneurysm-related risks."}