title: Intracerebral hemorrhages associated with neurointerventional procedures using a combination of antithrombotic agents including abciximab.
abstract: BACKGROUND
  We report the occurrence of fatal intracerebral hemorrhage associated with using a combination of antithrombotic agents, including abciximab, in patients undergoing neurointerventional procedures.
  
  
  METHODS
  Seven patients (average age 60, range 46 to 73 years) developed fatal intracerebral hemorrhages associated with neurointerventional procedures and the use of intravenous abciximab. The procedures included angioplasty and stent placement in the cervical internal carotid artery (n=4), angioplasty of the intracranial internal carotid artery (n=1), and angioplasty of the middle cerebral artery (n=2). Clinical deterioration was observed within 1 hour of the procedure in 5 patients and 7 and 8 hours after the procedure, respectively, in the remaining 2 patients. All patients had received heparin and clopidogrel; 6 had also received aspirin.
  
  
  CONCLUSIONS
  Intracerebral hemorrhages can occur after neurointerventional procedures in patients with recent cerebral ischemic events, particularly when aggressive antithrombotic treatment is used.
authors.affiliation: Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA. aiqureshi@hotmail.com
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
authors.forename: Mustafa
authors.initials: M
authors.lastname: Saad
authors.forename: Osama O
authors.initials: OO
authors.lastname: Zaidat
authors.forename: Jose I
authors.initials: JI
authors.lastname: Suarez
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Alexander
authors.forename: M
authors.initials: M
authors.lastname: Fareed
authors.forename: K
authors.initials: K
authors.lastname: Suri
authors.forename: Zulfiqar
authors.initials: Z
authors.lastname: Ali
authors.forename: L Nelson
authors.initials: LN
authors.lastname: Hopkins
mesh_terms: D000077284:Abciximab; D000046:Academic Medical Centers; D000368:Aged; D017130:Angioplasty / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D000925:Anticoagulants / Q000008:administration & dosage; D002340:Carotid Artery Diseases / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000175:diagnosis; D004359:Drug Therapy, Combination; D017809:Fatal Outcome; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery; D019635:Neurosurgical Procedures / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015607:Stents; D014057:Tomography, X-Ray Computed
chemical_list: D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab