ABSTRACT NUMBER: ESOC2026A1188 DUAL ANTIPLATELET THERAPY DURATION FOLLOWING STENT-ASSISTED MECHANICAL THROMBECTOMY-A REGIONAL CENTRE EXPERIENCE

Abstract Background and aims Carotid stenting during mechanical thrombectomy (MT) for tandem occlusions is established, yet the optimal duration of dual antiplatelet therapy (DAPT) following stent-assisted MT remains uncertain. Although guidelines (ESO and ESMINT) support antiplatelet therapy after carotid and intracranial stenting, MT-specific guidance on DAPT duration is lacking, potentially leading to practice variation and patient-safety risks, particularly during repatriation. We aimed to explore local patterns of DAPT duration and discharge documentation following stent-assisted MT. Methods We retrospectively reviewed all patients undergoing MT with permanent stent placement between 2018 and 2025. Data collected included demographics, indication for stenting, DAPT regimen and intended duration and documentation of stop or review dates. Practice was benchmarked against ESO/ESMINT guidance suggesting approximately 1–3 months of DAPT for intracranial stents, using a pragmatic 4–12-week reference band. Results Sixty-seven eligible cases were identified. Discharge summaries documented DAPT agents with an explicit duration, stop or review date in 50/67 cases (74.6%), while 16/67 (23.9%) lacked duration or review information. Intended DAPT duration was heterogeneous: 12 weeks was most common (27/67; 40.3%), followed by 24 weeks (7/67; 10.4%). When benchmarked against the 4–12-week reference range, 37/67 cases (55.2%) were within range, 13/67 (19.4%) were shorter, 7/67 (10.4%) exceeded 12 weeks and unknown duration 10/67 (14.9%). Conclusions Variation and poor documentation of DAPT duration after stent-assisted MT create avoidable patient-safety risks, particularly during repatriation. Standardised protocols and mandatory discharge documentation of DAPT regimen, intended duration and review dates are essential to prevent premature cessation or unnecessary prolongation of therapy. Conflict of interest Nothing to disclose