Higher preoperative ADP-induced LTA values were associated with postoperative DWI-positive lesions after SAC, but given the modest discriminative performance, ADP-induced LTA values should be interpreted as a supplementary reference rather than a standalone criterion for clinical decision-making.
The overall rate of DWI-positive lesions after stent-assisted coil embolization was 52.7%.
ADP-induced LTA values were significantly higher in the DWI-positive group compared to the DWI-negative group.
Propensity score matching with treatment period as a covariate was used to control for confounding in assessing the association between ADP-induced LTA and DWI positivity.
Dual antiplatelet therapy was administered at least 7 days before the procedure, with LTA measured on the day of the procedure for all included patients.
ADP-induced LTA demonstrated only modest discriminative performance for predicting DWI-positive lesions after SAC.
This research suggests that a blood test called light transmission aggregometry (LTA), which measures how well antiplatelet (blood-thinning) medications are working, can help predict whether patients will develop small silent strokes after a procedure called stent-assisted coil embolization (SAC) — a minimally invasive treatment for brain aneurysms. In a study of 548 patients, over half (52.7%) showed new spots on a specialized brain scan called diffusion-weighted imaging (DWI) after the procedure, though only 2 patients (0.4%) had actual symptoms. Patients whose blood clotted more despite antiplatelet medication — indicated by higher LTA values — were more likely to develop these silent brain lesions. The key finding is that higher ADP-induced LTA values (a measure of platelet activity) were statistically linked to a greater likelihood of DWI-positive lesions after the procedure. Patients in the group that developed DWI lesions had an average LTA value of 45.89, compared to 43.09 in those without lesions. This suggests that patients whose antiplatelet medications are less effective may face a higher risk of tiny procedural strokes, even if they don't feel any symptoms. However, the researchers caution that while this association is real and statistically significant, the test's ability to distinguish who will and who won't develop these lesions is only modest. This research suggests that LTA testing could be a useful additional tool to help doctors fine-tune antiplatelet therapy before this type of brain aneurysm procedure, but it should not be used alone to make treatment decisions — it works best as one piece of a larger clinical picture.
Kan I, Fuga M, Ishibashi T, Kato N, Hataoka S, Nagayama G, et al.. (2026). Role of light transmission aggregometry in predicting diffusion-weighted imaging lesions after stent-assisted coil embolization for intracranial aneurysms: a retrospective propensity score-matched study.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1857176