Intra-arterial abciximab for the treatment of thrombus formation during coil embolization of intracranial aneurysms

Linfante, Italo; Etezadi, Vahid; Andreone, Vincenzo; DeLeo, Michael; Alehashemi, Sara; Shaw, Kate; Wakhloo, Ajay K.

doi:10.1136/jnis.2009.001933

Cited by 28 publications

(27 citation statements)

References 21 publications

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“…Most of the thromboembolism reported previously was partially occluded thrombus detected at the coil−parent vessel interface 1 6 8 9 12. However, thromboembolism can develop anywhere during coil embolization, including areas proximal and distal to the aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Rescue mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms

Ahn

Jun

Song

et al. 2016

J NeuroIntervent Surg

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Section: Discussionmentioning

confidence: 99%

Rescue mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms

Ahn

Jun

Song

et al. 2016

J NeuroIntervent Surg

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] The infarction rate among patients receiving rescue therapy ranges between 10% and 40% with higher rates generally seen in studies with postoperative MR imaging [1][2][3][4][5][6][7][8][9][10][11][12][13][14] ( Table 5). In a series of 477 patients with 515 intracranial aneurysms, Ries et al 1 reported that 48 patients (10%) had thromboembolic events; 42 of these patients received rescue therapy with GpIIbIIIa inhibitors, and 1 patient received rescue therapy with recombinant tissue plasminogen activator.…”

Section: Discussionmentioning

confidence: 99%

“…Of the patients who did not receive rescue therapy, 3/5 had infarcts, whereas 31% of patients receiving GpIIbIIIa inhibitor rescue therapy had infarction on computed tomography. Linfante et al 10 demonstrated that ≈10% of patients undergoing endovascular embolization of intracranial aneurysms required intra-arterial GpIIbIIIa inhibitor rescue therapy with an infarct and hemorrhage rate of 0%. Many previous studies that have demonstrated high-infarct rates on postoperative imaging also highlight the fact that many of these infarcts are clinically silent.…”

Section: Discussionmentioning

confidence: 99%

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Rescue Treatment of Thromboembolic Complications During Endovascular Treatment of Cerebral Aneurysms

Brinjikji

McDonald

Kallmes

et al. 2013

Stroke

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Background and Purpose-Acute intraprocedural thrombus formation complicating endovascular cerebral aneurysm treatment is often treated with intra-arterial or intravenous administration of thrombolytic agents or glycoprotein IIb/IIIa (GpIIb/IIIa) inhibitors. We sought to evaluate the morbidity and mortality associated with such treatments using a large multihospital database. Methods-Using the Premier Perspective Database, we examined outcomes for patients receiving endovascular coiling for ruptured and unruptured aneurysms requiring rescue therapy, defined as treatment with GpIIb/IIIa inhibitors and fibrinolytic therapy. We compared discharge status, length of stay, and complication rates across 3 groups: (1) patients receiving GpIIb/IIIa inhibitors only, (2) patients receiving fibrinolytic therapy only, and (3)

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“…In comparison, the collective experience with similar use of intra-arterial abciximab (IAA) or tirofiban shows an average rate of complete recanalization of 73.9 and 67.7%, respectively (table 5) [9,13,14,15,16,17,18,19,20,21,22,23,24]. More studies are warranted in further exploring the efficacy of IAE.…”

Section: Discussionmentioning

confidence: 99%

Intra-Arterial Eptifibatide in the Management of Thromboembolism during Endovascular Treatment of Intracranial Aneurysms: Case Series and a Review of the Literature

et al. 2013

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Objectives: Thromboembolic complications are well recognized during the endovascular management of intracranial aneurysms. In this study, we present a case series of 40 patients with intraprocedural thrombotic complications who were treated with intra-arterial eptifibatide (IAE), and a review of the literature. Methods: Twenty-five patients with ruptured intracranial aneurysms (RIA), 10 with unruptured intracranial aneurysms (UIA) and 5 with aneurysmal subarachnoid hemorrhage-induced vasospasm (VSP) received IAE for intraprocedural thrombi during endovascular treatment. Rates of recanalization, strokes, and hemorrhagic complications were assessed. Results: Recanalization was achieved in 96% (24/25) of the RIA patients [72% (18/25) complete; 24% (6/25) partial], in 100% (10/10) of the UIA patients [90% (9/10) complete; 10% (1/10) partial], and in 100% (5/5) of the VSP patients [80% (4/5) complete; 20% (1/5) partial]. Strokes following intraprocedural thrombosis were coil-related (20%, 5/25) or stent-related (12%, 3/25) in RIA patients, stent-related (10%, 1/10) in UIA patients, and heparin-induced thrombocytopenia type II-related (60%, 3/5) or vasospasm-related (20%, 1/5) in VSP patients. There were no intracerebral hemorrhagic complications in UIA. Intracerebral hemorrhage was observed in 20% of the RIA patients (5/25), all of whom had received intra-arterial thrombolytics and/or high-dose heparin infusion in addition to IAE; in 12%, this was external ventricular drain-related (3/25), 4% had parenchymal hematoma type 1 (1/25), and 4% parenchymal hematoma type 2 (1/25). One of the 5 VSP patients, who had received argatroban in addition to IAE, had parenchymal hematoma type 1. No clinically significant systemic hemorrhage was observed in this study. Conclusion: Treatment of thromboembolic complications with IAE during endovascular management of aneurysms was effective in achieving recanalization and overall well tolerated in this series.

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Intra-arterial abciximab for the treatment of thrombus formation during coil embolization of intracranial aneurysms

Abstract: 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.

Cited by 28 publications

References 21 publications

Rescue mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms

Rescue mechanical thrombectomy using a retrievable stent for thromboembolic occlusion occurring during coil embolization of ruptured intracranial aneurysms

Rescue Treatment of Thromboembolic Complications During Endovascular Treatment of Cerebral Aneurysms

Intra-Arterial Eptifibatide in the Management of Thromboembolism during Endovascular Treatment of Intracranial Aneurysms: Case Series and a Review of the Literature

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