People with an intracranial aneurysm have a small bulge in a blood vessel inside the brain that can be treated by threading a thin tube through the arteries and placing tiny coils to block the bulge. During this procedure a medication called heparin is given through an IV to keep blood from clotting, and the study compares a lower dose (30 IU per kilogram of body weight) with a higher dose (70 IU per kilogram). In addition, a short‑acting drug called protamine sulfate may be used at the end of the procedure to neutralize the heparin, while patients also receive standard blood‑thinning medicines such as acetylsalicylic acid (aspirin) and ticagrelor to further reduce clot risk.
The purpose of the study is to find out which heparin dose best prevents tiny areas of reduced blood flow in the brain that are not felt as symptoms but can be seen on a brain scan called diffusion-weighted imaging (a type of MRI) performed about a day after the procedure. Participants are randomly assigned to one of the two dose groups, receive the medication during the embolization, stay in the hospital for monitoring, and have a brain scan 24 ± 12 hours later to check for these silent lesions, as well as to watch for any bleeding or stroke that might occur shortly after the treatment.
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