title: Abciximab treatment modalities for thromboembolic events related to aneurysm coiling.
abstract: BACKGROUND
  Thromboembolic complications are the most common cause of periprocedural morbidity associated with the endovascular treatment of intracranial aneurysms with detachable coils.
  
  
  OBJECTIVE
  To estimate the safety and efficacy of using combined intra-arterial and intravenous abciximab to treat thrombi complicating endovascular cerebral aneurysm coil embolization.
  
  
  METHODS
  In a retrospective analysis of 390 aneurysmal coiling procedures, we identified 39 patients (10.0%) with thromboembolic events related to the procedure. As the first line of treatment in 23 of these patients, abciximab was administered intra-arterially as a bolus followed by intravenous infusion over a 12-hour period. Eleven of the 23 patients were treated for ruptured aneurysms, 9 for unruptured aneurysms, and 3 for aneurysmal recanalization. Flow restoration and neurological outcome were evaluated.
  
  
  RESULTS
  Amelioration as measured by the Thrombolysis in Myocardial Infarction flow grade score was achieved in 17 of 23 patients (73.9%), and no change was observed in 6 of 23 patients (26.1%). Complete recanalization was achieved in 13 patients (56.5%). A greater response to abciximab was noted for thrombi at the coil-parent artery interface, and a lesser response was noted for distal thrombi. No hemorrhagic complications were noted for any of the patients, whereas 11 patients (47.8%) showed ischemic lesions. A modified Rankin Scale score of 2 or less was achieved in 17 of 23 patients (73.9%), whereas 6 of 23 patients (26.1%) had a modified Rankin Scale score of more than 2.
  
  
  CONCLUSIONS
  Combined intra-arterial/intravenous administration of abciximab is safe and effective for treating thromboembolic complications that occur during aneurysmal coil embolization with no hemorrhagic complications.
authors.affiliation: Neuroradiology Department, Hopital Maison Blanche, CHU Reims, Reims, France.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Aggour
authors.forename: Laurent
authors.initials: L
authors.lastname: Pierot
authors.forename: Krisztof
authors.initials: K
authors.lastname: Kadziolka
authors.forename: Philippe
authors.initials: P
authors.lastname: Gomis
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Graftieaux
mesh_terms: D000077284:Abciximab; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D013923:Thromboembolism / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab