Document Detail


Evaluation of glycoprotein IIb/IIIa inhibitors in carotid angioplasty and stenting.
MedLine Citation:
PMID:  12751927     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To review the immediate neurological and bleeding complications associated with the use of glycoprotein (GP) IIb/IIIa inhibitors in patients undergoing extracranial carotid artery stent placement.
METHODS: A retrospective review was performed of 550 patients (321 men; mean age 71.1 years, range 28-91) who underwent carotid artery angioplasty and stent placement. Glycoprotein IIb/IIIa inhibitors were given prophylactically along with heparin to 216 patients, whose outcomes were compared to a control group of 334 patients who received intravenous heparin alone. Primary endpoints were the immediate and 30-day neurological complications, including transient ischemic attacks (TIAs), minor and major strokes, and neurologically-related deaths. The secondary endpoint was any abnormal bleeding.
RESULTS: The all stroke/neurological death rate in 216 patients treated with heparin and GP IIb/IIIa inhibitors was 6.0% (13 events) compared 2.4% (8 events) in the 334 patients in the heparin-only control group (p=0.0430). Two of the 4 neurologically-related deaths in the GP IIb/IIIa inhibitor group resulted from intracranial hemorrhages; there were no intracranial hemorrhages in the heparin-only group. There was 1 episode of extracranial bleeding in the GP IIb/IIIa inhibitor group treated with embolization. The incidences of significant puncture-site bleeding requiring transfusion were similar in the groups.
CONCLUSIONS: Neurological complications following percutaneous carotid artery interventions have been relatively few. The neurological sequelae in carotid stent patients receiving glycoprotein IIb/IIIa inhibitors were more numerous and consequential, which suggests that the use of GP IIb/IIIa inhibitors in carotid stenting should be discouraged.
Authors:
Michael Henry Wholey; Mark Henry Wholey; Gustave Eles; Boulis Toursakissian; Steven Bailey; Chester Jarmolowski; Walter A Tan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  10     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-05-19     Completed Date:  2003-10-02     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  33-41     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Interventional Radiology, University of Texas Health Science Center at San Antonio, 78284, USA. wholey@uthscsa.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty*
Antibodies, Monoclonal / adverse effects*
Carotid Stenosis / surgery*
Case-Control Studies
Female
Heparin / administration & dosage
Humans
Immunoglobulin Fab Fragments / adverse effects*
Male
Middle Aged
Peptides / adverse effects*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Postoperative Complications / chemically induced,  epidemiology*
Retrospective Studies
Stents*
Treatment Outcome
Tyrosine / adverse effects*,  analogs & derivatives
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Peptides; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/eptifibatide; 144494-65-5/tirofiban; 55520-40-6/Tyrosine; 9005-49-6/Heparin; X85G7936GV/abciximab
Comments/Corrections
Comment In:
J Endovasc Ther. 2003 Feb;10(1):42-4   [PMID:  12751928 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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