[Perioperative Management to Avoid Complications in Endovascular Treatment of Cerebrovascular Diseases]

Neuroendovascular therapy is a minimally invasive treatment for various cerebrovascular diseases; however, its outcomes depend heavily on perioperative management. Antithrombotic control is particularly important in procedures using high-metal-burden devices such as stents and flow diverters. Although dual antiplatelet therapy (DAPT) is the standard strategy, variability in the clopidogrel response, especially due to CYP2C19 polymorphisms, necessitates individualized management supported by platelet function testing. Careful access evaluation and ultrasound-guided femoral puncture can also reduce access-site complications. Overall, a tailored and risk-balanced perioperative approach is essential to improve safety and outcomes.