RT Journal Article
SR Electronic
T1 Intra-arterial abciximab for the treatment of thrombus formation during coil embolization of intracranial aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 135
OP 138
DO 10.1136/jnis.2009.001933
VO 2
IS 2
A1 Italo Linfante
A1 Vahid Etezadi
A1 Vincenzo Andreone
A1 Michael DeLeo
A1 Sara Alehashemi
A1 Kate Shaw
A1 Ajay Wakhloo
YR 2010
UL http://jnis.bmj.com/content/2/2/135.abstract
AB Background and purpose Thrombus formation during endovascular embolization of intracranial aneurysms occurs in 2.9%–6% of patients. Use of IIb/IIIA inhibitors such as abciximab or eptifibatide intravenously has been reported in management of this complication. Because the intra-arterial infusion of IIb/IIIA inhibitors may require lower doses to achieve thrombolysis, it may reduce the risk of haemorrhage. Therefore, we retrospectively analyze our database and review the literature.Methods This is a retrospective analysis of a prospectively acquired database of patients with ruptured or unruptured aneurysm treated intra-arterially for thrombus formation during endovascular coil embolization between July 2005 and August 2008. Patient demographics, aneurysmal characteristics, procedural, clinical outcome and complications were recorded.Results From July 2005 to August 2008, out of 184 patients who underwent coil embolization, 19 patients (15 smokers, 14 female, mean age 52) developed intraprocedural thrombus formation and received intra-arterial abciximab treatment. Mean aneurysm size was 6.6 mm±4.9 mm; neck size was 3.8 mm±2.1 mm. Eight (42.1%) aneurysms were ruptured. Most aneurysms (63.1%) were in anterior communicating and middle cerebral arteries. Thrombus was visualized in all cases by angiogram and treated intra-arterially with a mean dose of 10.5 mg±4.2. There were no periprocedural hemorrhagic complications. No deaths or other complications occurred during follow-up.Conclusion Thrombus formation during coil embolization of intracranial aneurysms occurred more in women and smokers. Low doses of intra-arterial abciximab may be effective in the thromboembolic complications occurring during endovascular embolization of intracranial aneurysms.