ABSTRACT NUMBER: ESOC2026A1359 CLINICAL PROFILES AND PLATELET RESPONSE DIFFERENCES IN NEUROINTERVENTIONAL PATIENTS: CAROTID STENOSIS VERSUS INTRACRANIAL ANEURYSM PATHOLOGY

Abstract Background and aims Periprocedural management in neurointervention requires precise antiplatelet control due to the variability in individual responses. Hyporesponsiveness is associated with an increased risk of periprocedural thromboembolic events, whereas hyperresponsive patients exhibit a higher risk of hemorrhagic complications. This study compares baseline characteristics and platelet response profiles (ARU/PRU) between patients treated for carotid pathology and intracranial aneurysms. Methods We retrospectively analyzed 419 patients treated at Hospital Universitario Virgen del Rocío (Seville, Spain), including 214 with carotid pathology and 205 with intracranial aneurysms. Demographic variables, vascular risk factors, and comorbidities were collected. Platelet function was assessed using VerifyNow, and patients were classified as hyper-responders (PRU < 80), normo-responders (PRU 80–230), or non-responders (PRU > 230). Intergroup comparisons were performed. Results Patients in the carotid group were older (median age 69 vs. 57 years) and predominantly male (79% vs. 34%) compared with aneurysm patients (p < 0.001). Cardiovascular risk factors were significantly more prevalent in the carotid group, including diabetes mellitus (44% vs. 9.3%), hypertension (81% vs. 53%), and heart disease (23% vs. 6.8%) (all p < 0.001). Hyper-responsiveness was predominant among aneurysm patients (58%), whereas non-response was significantly more common in the carotid group (46%) (p < 0.001). Median PRU values were higher in carotid patients (223.5 vs. 63; p < 0.001). Conclusions Carotid patients exhibit a higher cardiovascular risk profile and greater biological resistance to antiplatelet therapy. Aneurysms patients exhibit a higher prevalence of hyper-responsiveness. These findings suggest the need for personalized antiplatelet protocols tailored to the neurovascular pathology being treated. Conflict of interest Nothing to disclose.