title: Administration of eptifibatide during endovascular treatment of ruptured cerebral aneurysms reduces the rate of thromboembolic events.
abstract: BACKGROUND
  Thromboembolic complications are the most frequent complications of endovascular treatment of ruptured intracranial aneurysms. The optimal protocol to prevent thromboembolic complications during coil embolization does not yet exist. The aim of this study was to investigate the effectiveness and safety of eptifibatide for the prevention of thromboembolic complications during elective coil embolization of ruptured cerebral aneurysms.
  
  
  METHODS
  A consecutive series of 100 patients (group 1) with ruptured intracranial aneurysm were treated using endovascular coil embolization. At the beginning of the procedure, all patients received an intra-arterial bolus (0.2 mg/kg) of eptifibatide. The following data were collected: degree of aneurysmal occlusion after treatment, thromboembolic and hemorrhagic complications and other intraoperative adverse events. The results were compared with those from a control group (group 2) which were analyzed retrospectively. Group 2 consisted of 100 previous patients with ruptured aneurysm managed with coil embolization who had received heparin and/or aspirin at the beginning of the procedure.
  
  
  RESULTS
  (1) Patient populations in groups 1 and 2 were considered statistically comparable, except that group 1 (eptifibatide) included more wide-necked aneurysms (p = 0.011). (2) There were less thromboembolic complications in group 1 (p = 0.011): seven intraoperative complications in group 1 versus 20 in group 2. (3) Intraoperative hemorrhagic complications were statistically comparable in both groups (p = 1).
  
  
  CONCLUSIONS
  Eptifibatide was effective in lowering the intraoperative thromboembolic complication rate in ruptured aneurysms treated with coil embolization and did not increase the hemorrhagic risk.
authors.affiliation: Unité de NeuroInterventionnelle, Hôpital St Roch, 5 rue Pierre Devoluy, Nice, 06000, France, jsedat@yahoo.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Sedat
authors.forename: Yves
authors.initials: Y
authors.lastname: Chau
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudard
authors.forename: Laurent
authors.initials: L
authors.lastname: Suissa
authors.forename: Sylvain
authors.initials: S
authors.lastname: Lachaud
authors.forename: Michel
authors.initials: M
authors.lastname: Lonjon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000379:methods; D000077542:Eptifibatide; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011859:Radiography; D013923:Thromboembolism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide