Local Delivery Versus Intracoronary Infusion of Abciximab in Patients With Acute Coronary Syndromes

Prati, Francesco; Capodanno, Davide; Pawłowski, Tomasz; Ramazzotti, Vito; Albertucci, Mario; Manna, Alessio La; Salvo, Marilena Di; Gil, Robert; Tamburino, Corrado

doi:10.1016/j.jcin.2010.05.017

Cited by 74 publications

(53 citation statements)

References 26 publications

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“…Thrombectomy is a widespread technical solution in the management of patients with ST 14 and is a prerequisite for OCT assessment, as thrombotic formations can hamper visualization of struts and vessel walls. 15,16 The pharmacologic treatment was given according to standard clinical practice. Most of patients received dual antiplatelet drugs with loading dose when required (clopidogrel bolus of 600 mg plus 75 mg/d or prasugrel bolus of 60 mg plus 10 mg/d) and aspirin 100 mg/d (Table I), whereas glycoprotein IIb/IIIa inhibitors were given at physician's discretion.…”

Section: Procedural Details and Definitionsmentioning

confidence: 99%

Suboptimal stent deployment is associated with subacute stent thrombosis: Optical coherence tomography insights from a multicenter matched study. From the CLI Foundation investigators: the CLI-THRO study

Prati¹,

Kodama

Romagnoli

et al. 2015

American Heart Journal

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Section: Procedural Details and Definitionsmentioning

confidence: 99%

Suboptimal stent deployment is associated with subacute stent thrombosis: Optical coherence tomography insights from a multicenter matched study. From the CLI Foundation investigators: the CLI-THRO study

Prati¹,

Kodama

Romagnoli

et al. 2015

American Heart Journal

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“…To avoid these limitations, abciximab may be delivered directly to the infarct lesion site through a drug delivery catheter and when delivered in this manner reduces thrombus to a greater extent than when given through the guide catheter. 13 Conflicting data on the efficacy of thrombus aspiration have also been reported, with the positive results from single-center studies not confirmed in multicenter trials. 14,15 Nor have studies of thrombus aspiration demonstrated improved in-stent flow areas after primary PCI 16 or reduced infarct size, 17 the presumed mechanism through which clinical benefit would be realized.…”

Section: Circ Cardiovasc Intervmentioning

confidence: 99%

Intralesional Abciximab and Thrombus Aspiration in Patients With Large Anterior Myocardial Infarction

Stone

Witzenbichler

Godlewski

et al. 2013

Circ: Cardiovascular Interventions

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By achieving high local drug concentrations, intracoronary abciximab may be more effective in reducing platelet thromboemboli than when administered intravenously. 7,8 However,Background-Whether intralesional abciximab administration and thrombus aspiration confer clinical benefits to patients undergoing primary percutaneous coronary intervention for ST-segment-elevation myocardial infarction is controversial. Methods and Results-A total of 452 patients with ST-segment-elevation myocardial infarction caused by proximal or mid left anterior descending artery occlusion undergoing primary percutaneous coronary intervention with bivalirudin anticoagulation were randomized in a 2×2 factorial design to bolus abciximab delivered locally at the infarct lesion site versus no abciximab and to manual thrombus aspiration versus no aspiration. Treatment with intralesional abciximab, thrombus aspiration, or both therapies compared with no active therapy before stent implantation resulted in lower 1-year rates of death (4.5% versus 10.4%; P=0.03), severe heart failure (4.2% versus 10.3%; P=0.02), and stent thrombosis (0.9% versus 3.8%; P=0.046). Between 30 days and 1 year of follow-up, treatment with intralesional abciximab compared with no abciximab was associated with a lower rate of death (1.4% versus 4.9%; P=0.04) and composite major adverse ischemic events (3.3% versus 7.8%; P=0.04), with nonsignificantly different overall 1-year rates of mortality, composite ischemic events, and heart failure-related events. Thrombus aspiration compared with no aspiration was associated with lower rates of new-onset severe heart failure between 30 days and 1 year (0.9% versus 4.5%; P=0.02) and of rehospitalization for heart failure from randomization to 1 year (0.9% versus 5.4%; P=0.0008), with nonsignificantly different rates of mortality. Conclusions-Intralesional abciximab and thrombus aspiration may have long-term benefits in patients with anterior STsegment-elevation myocardial infarction presenting early after symptom onset and undergoing primary percutaneous coronary intervention with bivalirudin anticoagulation. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00976521.(Circ Cardiovasc Interv. 2013;6:527-534.)

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“…Significantly lower rates of procedure-related AMI and major adverse cardiac events at 1 year were observed in the local intracoronary infusion group. These results strongly suggest that the use of the dedicated perfusion catheter leads to higher concentrations of abciximab within the thrombus, allowing for an additional antiplatelet, antithrombotic, and anti--inflammatory effect [59].…”

Section: Abciximabmentioning

confidence: 70%

“…This method does not assure an www.cardiologyjournal.org optimal effect of abciximab, with the rapid wash out by the coronary flow. Prati et al [59] tested the effectiveness of local abciximab delivery to the site of IC thrombus vs. IC bolus infusion in patients with ACS undergoing PCI. For local IC delivery of abciximab a dedicated perfusion catheter was applied.…”

Section: Abciximabmentioning

confidence: 99%

Off-target effects of glycoprotein IIb/IIIa receptor inhibitors

et al. 2014

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Local Delivery Versus Intracoronary Infusion of Abciximab in Patients With Acute Coronary Syndromes

Abstract: Local intracoronary delivery of abciximab by means of a dedicated perfusion catheter reduces thrombus burden with the potential to improve coronary microcirculation.

Cited by 74 publications

References 26 publications

Suboptimal stent deployment is associated with subacute stent thrombosis: Optical coherence tomography insights from a multicenter matched study. From the CLI Foundation investigators: the CLI-THRO study

Suboptimal stent deployment is associated with subacute stent thrombosis: Optical coherence tomography insights from a multicenter matched study. From the CLI Foundation investigators: the CLI-THRO study

Intralesional Abciximab and Thrombus Aspiration in Patients With Large Anterior Myocardial Infarction

Off-target effects of glycoprotein IIb/IIIa receptor inhibitors

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