Abciximab for treatment of thromboembolic complications during endovascular coiling of intracranial aneurysms.
OBJECTIVE
Thromboembolism is a recognized complication occurring during endovascular coil embolization of intracranial aneurysms. Recently, there has been much interest in glycoprotein IIb/IIIa inhibitors to treat such complications, but the evidence is limited. We reviewed our use of one such agent, abciximab, which we commonly administer and believe to be a safe and suitable rescue agent in this setting.


METHODS
We retrospectively reviewed cases in which abciximab was administered in our institution between 2001 and 2007. Clinical outcome was assessed by the modified Rankin Scale (mRS) at 6 months. Good outcome was defined as no significant clinical sequelae compared with baseline status or clinical improvement (mRS < 2). Poor outcome was defined as no resolution of a new clinical deficit that developed postprocedure at 6 months (mRS > 2). Angiographic appearance of thromboembolic phenomena and posttreatment outcome was assessed with the Thrombolysis in Myocardial Infarction (TIMI) scale.


RESULTS
Thirty-eight patients were included, with good outcome observed in 30 (79%) and poor outcome in 8 (21%) patients. Angiographic improvement based on TIMI scoring was seen in 24 (63%) patients, and no improvement was seen in 14 (37%). In 4 patients (11%), good outcome was obtained at 6 months despite no angiographic improvement on TIMI. No cases of intracranial rebleed or additional neurologic deficit following administration of abciximab were encountered.


CONCLUSIONS
In this small retrospective series, abciximab was safe and effective when used as a rescue agent for thromboembolic complications encountered during coiling of intracerebral aneurysms.
Jones
R G
RG
Department of Interventional Radiology, University Hospital Birmingham, Queen Elizabeth Medical Centre, Birmingham, UK. jonesradiology@gmail.com
Davagnanam
I
I
Colley
S
S
West
R J
RJ
Yates
D A
DA
D000077284:Abciximab; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D000925:Anticoagulants / Q000008:administration & dosage; D015897:Comorbidity; D004621:Embolization, Therapeutic / Q000706:statistics & numerical data*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D015994:Incidence; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000628:therapy*; D020766:Intracranial Embolism / Q000188:drug therapy* / Q000453:epidemiology*; D020767:Intracranial Thrombosis / Q000188:drug therapy* / Q000453:epidemiology*; D008875:Middle Aged; D012189:Retrospective Studies; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab
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