Abciximab bolus injection does not reduce cerebral ischemic complications of elective carotid artery stenting: a randomized study.
OBJECTIVE
Abciximab has been shown to significantly reduce thromboembolic complications of coronary artery stenting. A prospective, randomized study was performed to test whether abciximab has comparable beneficial effects in carotid artery stenting.


METHODS
Seventy-four consecutive patients undergoing elective stenting of the carotid artery were included in the study. Standard antithrombotic medication consisted of aspirin, clopidogrel, and heparin. In addition, half of the patients received an abciximab bolus of 0.25 mg/kg body weight given prophylactically before the intervention.


RESULTS
The procedure was successful in all but 1 patient. In patients receiving abciximab, ischemic complications consisted of 4 transient ischemic attacks, 1 minor stroke, 1 nonfatal major stroke, and 1 fatal stroke caused by cerebral hemorrhage. In the control group, 2 transient ischemic attacks and 1 major nonfatal stroke occurred. In summary, the total number of periprocedural ischemic events was 7 (19%) in the abciximab group and 3 (8%) in the control group. Nonischemic complications consisted of 1 inguinal hematoma requiring blood transfusions in each group.


CONCLUSIONS
Abciximab bolus given prophylactically before elective carotid artery stenting does not reduce ischemic complications.
Hofmann
Robert
R
Cardiovascular Division, City Hospital Linz, Linz, Austria. robert.hofmann@akh.linz.at
Kerschner
Klaus
K
Steinwender
Clemens
C
Kypta
Alexander
A
Bibl
Dietmar
D
Leisch
Franz
F
D000077284:Abciximab; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002545:Brain Ischemia / Q000209:etiology* / Q000517:prevention & control*; D002340:Carotid Artery Diseases / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D017211:Treatment Failure; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab