Short-term safety of dual versus single antiplatelet therapy in flow diversion for distal intracranial aneurysms: results from the DART trial.
J Neurointerv SurgSep 14, 2026 (epub)
Clinical ResearchNeurosurgery
Luis Henrique de Castro-Afonso, Saulo Villas-Boas, Guilherme Seizem Nakiri et al.
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In 30 seconds
The DART trial evaluated the short-term safety of prasugrel monotherapy versus dual antiplatelet therapy (DAPT) in 129 patients undergoing flow diversion for distal intracranial aneurysms. The study found that 98.5% of patients on monotherapy and 95.2% on DAPT had no new neurological deficits at 30 days, confirming the non-inferiority of monotherapy (difference 3.35%, p=0.002).
Key findings
- 98.5% of the MAPT group had no new neurological deficits at 30 days.
- 95.2% of the DAPT group had no new neurological deficits at 30 days.
- The difference of 3.35% confirmed the non-inferiority of MAPT compared to DAPT (p=0.002).
- Stroke incidence was 5.9% in the MAPT group and 9.6% in the DAPT group (p=0.431).
Why it matters
This study provides evidence that prasugrel monotherapy may be a safe alternative to dual antiplatelet therapy for patients undergoing flow diversion for distal intracranial aneurysms, potentially simplifying treatment regimens and reducing medication burden.