Abstract | BACKGROUND: Standard pretreatment with dual antiplatelet medication ( DAPM) was compared with a standalone intraprocedural abciximab bolus for the prevention of thromboembolic and hemorrhagic events during endovascular stenting of unruptured intracranial aneurysms. MATERIALS AND METHODS: We treated 94 patients with 99 aneurysms with intracranial stenting (with or without coiling). Patients were either pretreated with DAPM daily for ≥3 days before stenting (pretreatment group) or received an abciximab bolus during or immediately after stent placement followed by postoperative DAPM ( abciximab group), at the treating physician's discretion. Twenty patients underwent immediate postoperative MRI. Demographic, clinical, and radiological information and periprocedural complications were recorded. RESULTS: There were 52 procedures in the pretreatment group and 47 in the abciximab group. More flow-diverting stents were placed in the pretreatment group than in the abciximab group (45 vs 23, p<0.001), and the aneurysm diameter was larger (11.2±6.7 vs 8.3±4.7 mm, p=0.01). There were 11 thrombotic and 7 access site complications, with no significant difference between the groups (p>0.99 and p=0.12, respectively). There were no intracranial hemorrhages. In patients with postoperative MRI, there was no difference in the presence of diffusion-restricted lesions between groups (p=0.20). Multivariate analysis of a composite of any complication did not show significant associations with aneurysm or patient variables in either group. CONCLUSIONS: Standalone intraprocedural abciximab bolus was not associated with an increased rate of complications compared with pretreatment with DAPM for unruptured intracranial aneurysm stenting.
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Authors | Michael R Levitt, Karam Moon, Felipe C Albuquerque, Celene B Mulholland, M Yashar S Kalani, Cameron G McDougall |
Journal | Journal of neurointerventional surgery
(J Neurointerv Surg)
Vol. 8
Issue 9
Pg. 909-12
(Sep 2016)
ISSN: 1759-8486 [Electronic] England |
PMID | 26354945
(Publication Type: Journal Article)
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Copyright | Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ |
Chemical References |
- Antibodies, Monoclonal
- Immunoglobulin Fab Fragments
- Platelet Aggregation Inhibitors
- Abciximab
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Topics |
- Abciximab
- Administration, Oral
- Adult
- Aged
- Antibodies, Monoclonal
(administration & dosage)
- Combined Modality Therapy
- Diffusion Magnetic Resonance Imaging
- Drug Administration Schedule
- Drug Therapy, Combination
- Embolization, Therapeutic
(methods)
- Endovascular Procedures
(methods)
- Female
- Humans
- Immunoglobulin Fab Fragments
(administration & dosage)
- Infusions, Intravenous
- Intracranial Aneurysm
(diagnosis, therapy)
- Male
- Middle Aged
- Multivariate Analysis
- Platelet Aggregation Inhibitors
(administration & dosage)
- Premedication
- Stents
(adverse effects)
- Treatment Outcome
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