Thu Sep 26 14:00:00 UTC 2024: ## Aspirin Before Brain Aneurysm Surgery: A New Trial Aims to Prove Its Benefits

**Tokyo, Japan** – A new multicenter clinical trial, called ASTOP, is investigating the safety and efficacy of administering aspirin before endovascular treatment (EVT) for ruptured cerebral aneurysms. Led by researchers from Tokyo Medical and Dental University, the trial aims to determine if pre-operative aspirin can reduce the risk of thromboembolic complications during surgery.

Thromboembolism is a serious complication that can occur during EVT, a minimally invasive procedure to repair a brain aneurysm. While antiplatelet agents like aspirin are commonly used after surgery, their use before surgery has been debated due to concerns about increased bleeding risk.

ASTOP is a randomized, double-blind, placebo-controlled trial involving 484 patients with ruptured cerebral aneurysms. Patients will be randomly assigned to receive either 200mg of aspirin or a placebo before undergoing EVT. The primary outcomes will be the incidence of intraoperative thromboembolic complications and symptomatic ischemic lesions detected by MRI scans.

The trial will also assess secondary outcomes such as the incidence of cerebral ischemic events, bleeding events, and functional outcomes measured by the modified Rankin Scale score at 90 days.

The researchers believe that pre-operative aspirin administration may improve outcomes by preventing thrombus formation during EVT. The study will provide valuable data to inform clinical practice and potentially change the standard of care for patients with ruptured cerebral aneurysms undergoing EVT.

**”This is the first RCT to investigate the usefulness of antiplatelet agents in neuro-EVT,”** says Dr. Sumita, lead researcher on the ASTOP study. **”This study is expected to change the routine clinical protocol of EVT for RAs, leading to safer and more effective treatments.”**

The ASTOP trial began in January 2022 and is expected to be completed by December 2024. As of February 2024, 256 patients have been recruited.

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