Abciximab for thrombolysis during intracranial aneurysm coiling.
BACKGROUND
Thrombotic events are a common and severe complication of endovascular aneurysm treatment with significant impact on patients' outcome. This study evaluates risk factors for thrombus formation and assesses the efficacy and safety of abciximab for clot dissolution.


METHODS
All patients treated with abciximab during (41 patients) or shortly after (22 patients) intracranial aneurysm coil embolisation were retrieved from the institutional database (2000 to 2007, 1,250 patients). Sixty-three patients (mean age, 55.3 years, +/- 12.8) had received either intra-arterial or intravenous abciximab. Risk factors for clot formation were assessed and the angiographic and clinical outcome evaluated.


RESULTS
No aneurysm rupture occurred during or after abciximab application. The intra-procedural rate of total recanalisation was 68.3%. Thromboembolic complications were frequently found in aneurysms of the Acom complex and of the basilar artery, whilst internal carotid artery aneurysms were underrepresented. Two patients died of treatment-related intracranial haemorrhages into preexisting cerebral infarcts. Two patients developed a symptomatic groin haematoma.


CONCLUSIONS
Abciximab is efficacious and safe for thrombolysis during and after endovascular intracranial aneurysm treatment in the absence of preexisting ischaemic stroke.
Gralla
Jan
J
Department of Neuroradiology, West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford, UK. jan.gralla@insel.ch
Rennie
Adam T M
AT
Corkill
Rufus A
RA
Lalloo
Shivendra T
ST
Molyneux
Andrew
A
Byrne
James V
JV
Kuker
Wilhem
W
D000077284:Abciximab; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use*; D015331:Cohort Studies; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D020767:Intracranial Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D000925:Anticoagulants; D007140:Immunoglobulin Fab Fragments; D000077284:Abciximab