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New research · Neurology
Annals of medicine · 4d
Cohort studyAnnals of medicine · 2026

Impact of antithrombotic therapy on outcomes of incidental unruptured intracranial aneurysms in patients with ischemic stroke.

Chao Chen, Yiya Xu, Yingchao He … Xingyong Chen
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NeurologyCohort study

Anticoagulation was not associated with lower odds of aneurysm rupture.

Impact of antithrombotic therapy on outcomes of incidental unruptured intracranial aneurysms in patients with ischemic stroke.

Chao Chen … Xingyong Chen
Annals of medicine · 2026
Background

The coexistence of acute ischemic stroke (acute ischemic stroke) and unruptured intracranial aneurysms (unruptured intracranial aneurysms) is relatively common, but the safety of antithrombotic therapy in this population remains uncertain.

Purpose

This study evaluated whether different secondary prevention regimens influence unruptured intracranial aneurysms progression or rupture risk.

Methods

Were categorized according to long-term antithrombotic exposure: single antiplatelet therapy (single antiplatelet therapy), anticoagulation, or no regular therapy.

n = 197 patients
Results

Odds of aneurysm rupture with anticoagulation were not significantly lower than single antiplatelet therapy.

OR by subgroup · 95% CI
null = 1
antithrombotic regimen and aneurysm
0.41
upture
3.21
More results

Among 197 patients (mean age 68.4 ± 10.2 years; 53.8% female), 140 received single antiplatelet therapy, 36 received anticoagulation, and 21 received no regular therapy.

No ruptures occurred in the anticoagulation group.

“
Conclusion · 1 of 2

In patients with small incidental saccular unruptured intracranial aneurysms and acute ischemic stroke, standard secondary prevention regimens were not associated with an increased risk of aneurysm rupture.

Conclusion · 2 of 2

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.

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