Abciximab for thrombolysis during intracranial aneurysm coiling

• Published in: Neuroradiology Vol. 50; no. 12; pp. 1041 - 1047
• Main Authors: Gralla, Jan, Rennie, Adam T. M., Corkill, Rufus A., Lalloo, Shivendra T., Molyneux, Andrew, Byrne, James V., Kuker, Wilhem
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-12-2008; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Aneurysm, Ruptured - complications; Aneurysm, Ruptured - diagnostic imaging; Aneurysm, Ruptured - therapy; Aneurysms; Antibodies, Monoclonal - therapeutic use; Anticoagulants - therapeutic use; Biological and medical sciences; Blood clots; Brain surgery; Clinical outcomes; Cohort Studies; Drug therapy; Embolization, Therapeutic - adverse effects; Female; Humans; Imaging; Immunoglobulin Fab Fragments - therapeutic use; Interventional Neuroradiology; Intracranial Aneurysm - complications; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - therapy; Intracranial Thrombosis - diagnostic imaging; Intracranial Thrombosis - etiology; Intracranial Thrombosis - prevention & control; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Nervous system; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiography; Radiology; Retrospective Studies; Surgical techniques; Thrombolytic Therapy; Treatment Outcome; Thromboembolic complication; Abciximab; Endovascular treatment; Aneurysm; Vascular disease; Intracranial; Endovascular treatment . Thromboembolic complication; Nervous system diseases; Treatment; Radiodiagnosis; Cardiovascular disease; Complication; Endovascular route
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-008-0457-8

Introduction
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.
Materials and 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.