Document Detail


Intracarotid abciximab injection to abort impending ischemic stroke during carotid angioplasty.
MedLine Citation:
PMID:  11385208     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Abciximab, a platelet glycoprotein IIb/IIIa receptor antagonist, prevents ischemic complications during percutaneous transluminal coronary angioplasty and was recently shown to open occluded vessels in patients with acute myocardial infarction when used alone or in combination with other thrombolytic agents. In an animal model of arterial thrombosis, abciximab was found to be safe and effective for the prevention of carotid artery thrombosis. However, the safety and efficacy of abciximab in the treatment of acute ischemic cerebrovascular events is unknown at present. CASE DESCRIPTION: We describe 3 patients who experienced ischemic cerebrovascular events with symptoms involving the middle cerebral artery territory while undergoing percutaneous angioplasty and stenting to their internal carotid arteries. Abciximab was administered to each patient within 10 min of symptom onset as a bolus (0.25 mg/kg) into the ipsilateral common carotid artery followed by continuous intravenous infusion (9 microg/min) for 12 h. All patients' symptoms resolved completely (by 25 min, 40 min and 5 h, respectively) with no further neurological complications. CONCLUSIONS: Our preliminary observation suggests that abciximab may improve neurological outcome following middle cerebral artery ischemic events associated with carotid angioplasty and stenting. Large prospective studies are warranted to establish the safety and efficacy of abciximab in acute ischemic stroke, either as a primary treatment modality or an adjunct to carotid angioplasty and stenting.
Authors:
D S Ho; Y Wang; M Chui; Y Wang; S L Ho; R T Cheung
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  11     ISSN:  1015-9770     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2001  
Date Detail:
Created Date:  2001-05-31     Completed Date:  2002-10-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  300-4     Citation Subset:  IM    
Copyright Information:
Copyright 2001 S. Karger AG, Basel.
Affiliation:
Division of Cardiology, Queen Mary Hospital Department of Medicine, The University of Hong Kong, Hong Kong. dswho@hku.hk
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty*
Antibodies, Monoclonal / administration & dosage,  therapeutic use*
Brain Ischemia / prevention & control*
Carotid Artery, Common / surgery*
Cerebral Angiography
Female
Humans
Immunoglobulin Fab Fragments / administration & dosage,  therapeutic use*
Injections, Intra-Arterial
Intraoperative Complications / prevention & control
Male
Middle Cerebral Artery / pathology
Platelet Aggregation Inhibitors / administration & dosage,  therapeutic use*
Stents
Stroke / prevention & control*
Tomography, Emission-Computed, Single-Photon
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 143653-53-6/abciximab

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