P005 The SAFEST study: survey on antiplatelets in flow diversion for aneurysm endovascular treatment

<h3>Introduction</h3> Flow diversion has emerged as a promising treatment strategy for intracranial aneurysms, yet the influence of antiplatelet therapy on treatment outcomes remains uncertain. Variability in antiplatelet regimen usage further complicates treatment standardization. <h3>Aim of Study</h3> This survey aimed to investigate common practices of antiplatelet medication usage in flow diversion for intracranial aneurysms worldwide. <h3>Methods</h3> An anonymous online survey explored antiplatelet therapy aspects in neurointerventions, including agent selection, dosing, and duration. The survey was distributed through international neurointerventional societies, including ESMINT, and mailing lists. <h3>Results</h3> 442 respondents from 53 countries participated, revealing heterogeneity in antiplatelet protocols. DAPT, primarily combining low-dose aspirin with clopidogrel (68%), was the most common approach. However, alternative P2Y12 inhibitors are increasingly being used with the main reasons for preferring ticagrelor (21%) over prasugrel (10%) being availability and bleeding risk, while the main reason for using prasugrel over ticagrelor is patient compliance. Resistance testing for antiplatelet agents was conducted by 62% of responders, with the VerifyNow system being the most popular method. Strategies to manage resistance included dose escalation (17%) and switching (83%) to alternative agents. Interest in participating in future trials investigating antiplatelet therapy duration and SAPT versus DAPT was high (77% and 58%, respectively). <h3>Conclusion</h3> Antiplatelet therapy practices following flow diversion procedures vary globally, with a growing interest in alternative agents and a willingness to participate in future trials. Standardization efforts and further investigation are crucial for optimizing neurointerventional outcomes. <h3>Disclosure of Interest</h3> no.