Glycoprotein IIb-IIIa receptor inhibition with eptifibatide in percutaneous intervention for symptomatic peripheral vascular disease: the circulate pilot trial.
The benefits of glycoprotein (GP) IIb-IIIa inhibitors in percutaneous coronary intervention are well established, but the experience with these agents in the setting of peripheral interventions is limited. In this single-center pilot trial, the safety and feasibility of adjunctive treatment with the GP IIb-IIIa inhibitor eptifibatide (INTEGRILIN, Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, and Schering-Plough Corporation, Kenilworth, New Jersey) was evaluated in 85 patients undergoing percutaneous transluminal angioplasty or stenting for severe claudication or critical limb ischemia. Eptifibatide treatment was safe, with low rates of major bleeding (3.5%) and thrombocytopenia (1.2%); one patient developed a post-procedure compartment syndrome requiring fasciotomy. The procedure was technically successful (defined as <30% residual stenosis or >50% increase in vessel diameter) in 84 of 85 (98.8%) patients. None of the patients required target vessel revascularization (TVR) during hospitalization, and only 1 patient (1.2%) required TVR within 30 days. These results demonstrate that adjunctive use of eptifibatide during percutaneous peripheral intervention is safe and supports further studies to establish the potential efficacy of GP IIb-IIIa inhibitors in this setting.
Rocha-Singh
Krishna J
KJ
Vascular Medicine Program, Prairie Heart Institute, St. John's Hospital, 619 East Mason Street, Suite 4P57, Springfield, IL 62701, USA. ksingh@prairieheart.com
Rutherford
Janiece
J
D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D000077542:Eptifibatide; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010455:Peptides / Q000627:therapeutic use*; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011150:Popliteal Artery; D011446:Prospective Studies; D016896:Treatment Outcome
D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide