Document Detail

Abciximab treatment modalities for thromboembolic events related to aneurysm coiling.
MedLine Citation:
PMID:  21099579     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Thromboembolic complications are the most common cause of periprocedural morbidity associated with the endovascular treatment of intracranial aneurysms with detachable coils.
OBJECTIVE: To estimate the safety and efficacy of using combined intra-arterial and intravenous abciximab to treat thrombi complicating endovascular cerebral aneurysm coil embolization.
METHODS: In a retrospective analysis of 390 aneurysmal coiling procedures, we identified 39 patients (10.0%) with thromboembolic events related to the procedure. As the first line of treatment in 23 of these patients, abciximab was administered intra-arterially as a bolus followed by intravenous infusion over a 12-hour period. Eleven of the 23 patients were treated for ruptured aneurysms, 9 for unruptured aneurysms, and 3 for aneurysmal recanalization. Flow restoration and neurological outcome were evaluated.
RESULTS: Amelioration as measured by the Thrombolysis in Myocardial Infarction flow grade score was achieved in 17 of 23 patients (73.9%), and no change was observed in 6 of 23 patients (26.1%). Complete recanalization was achieved in 13 patients (56.5%). A greater response to abciximab was noted for thrombi at the coil-parent artery interface, and a lesser response was noted for distal thrombi. No hemorrhagic complications were noted for any of the patients, whereas 11 patients (47.8%) showed ischemic lesions. A modified Rankin Scale score of 2 or less was achieved in 17 of 23 patients (73.9%), whereas 6 of 23 patients (26.1%) had a modified Rankin Scale score of more than 2.
CONCLUSION: Combined intra-arterial/intravenous administration of abciximab is safe and effective for treating thromboembolic complications that occur during aneurysmal coil embolization with no hemorrhagic complications.
Mohamed Aggour; Laurent Pierot; Krisztof Kadziolka; Philippe Gomis; Jean-Pierre Graftieaux
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  67     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-11-01     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  503-8     Citation Subset:  IM    
Neuroradiology Department, Hopital Maison Blanche, CHU Reims, Reims, France.
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MeSH Terms
Antibodies, Monoclonal / administration & dosage*
Blood Vessel Prosthesis Implantation / adverse effects*,  instrumentation,  methods
Embolization, Therapeutic / adverse effects*,  instrumentation,  methods
Immunoglobulin Fab Fragments / administration & dosage*
Intracranial Aneurysm / complications,  therapy*
Middle Aged
Platelet Aggregation Inhibitors / administration & dosage*
Retrospective Studies
Thromboembolism / drug therapy*,  etiology
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; X85G7936GV/abciximab

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