Vascular complications after percutaneous coronary interventions using abciximab (Reopro ): prospective evaluation with Doppler color flow imaging.
The aim of our study was to assess the incidence and consequences of vascular access site complications (VASC) associated with abciximab treatment in patients undergoing percutaneous transluminal coronary angioplasty (PTCA).


METHODS
Between July 1996 and November 1997, 120 patients underwent PTCA with adjunctive abciximab (n = 60) or without it (n = 60). VASC were assessed within 24 hours of PTCA completion by physical examination and Doppler color flow imaging (DCFI) of the groin.


RESULTS
A total of 24 VASC were observed mostly in abciximab patients (30% vs. 10%; p = 0.006) and only half of them were suspected on physical examination. Abciximab administration [odds ratio (OR) = 3.1; 95% confidence interval (CI) = 1.03Eth 9.0; p = 0.001], platelet fall > 40% (OR = 5.0; CI = 1. 03Eth 24.6; p = 0.045), and double-wall femoral artery puncture (OR = 5.3; CI = 1.9Eth 14.7; p = 0.001) carried a high probability of VASC after multivariate analysis. Vascular repair was needed in 10% of abciximab patients.


CONCLUSIONS
Aggressive antiplatelet drugs adjunctive to the anticoagulation treatment may result in an increased rate of VASC after PTCA. The use of refined catheterization techniques is advised to avoid VASC associated with abciximab administration. DCFI is recommended in the patients with abnormal groin finding or significant platelet fall after PTCA.
Kranjec
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Department of Cardiology, University Medical Center, Zaloska 7, 1000, Ljubljana, Slovenia. igor.kranjec@kclj.si
Cerne
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D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D002408:Catheters, Indwelling / Q000009:adverse effects; D003327:Coronary Disease / Q000628:therapy; D018618:Echocardiography, Doppler, Color; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects* / Q000627:therapeutic use; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D014652:Vascular Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000209:etiology
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab