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Abciximab Helpful in Thrombosis During Intracranial Aneurysm Repair: Presented at RSNA
The glycoprotein IIb/IIIA platelet activation inhibitor abciximab (ReoPro) appears successful in stopping thrombosis in patients who are undergoing intracranial aneurysm correction procedures, researchers said here at the 92nd scientific assembly and annual meeting of the Radiological Society of North America (RSNA).
In what is believed to be the largest case series evaluation of the use of abciximab in this setting, researchers found that use of the drug was associated with an acceptable outcome. Even when the outcome was poor, researchers did not see any rebleeding or other characteristic that would have been a problem with abciximab administration.
Researchers defined good outcome as a patient who did not develop suspected deficits secondary to witnessed thromboembolism or clinical signs improving following abciximab administration. Poor outcomes were clinical deficits or additional signs compared with baseline.
"Abciximab is an effective treatment for intraprocedural and postprocedure thrombosis in patients undergoing endovascular coil embolization," said Robert Jones, MBChB, consultant radiologist, University Hospital Birmingham, Birmingham, United Kingdom. "It is effective as a rescue medication in urgent situations."
Despite the use of anticoagulants during coiling of intracranial aneurysms, thromboembolic complication rates remain at 2% to 3%, Dr. Jones explained. "Treatment options are limited and have included angioplasty and thrombolytic drugs," he said.
"More recently, largely based on proven use in cardiology, abciximab is now used as a rescue agent for acute thromboembolic events occurring during coiling of intracerebral aneurysms. Scientific evidence to support its use in this setting is limited to a few small case series and case reports," he added.
Dr. Jones and colleagues performed a retrospective review of 33 cases -- 13 in women, 20 in men -- in which abciximab was given either as a bolus injection or was infused in patients undergoing aneurysm embolization in which thromboembolism was observed or expected. In 27 cases, doctors observed an aneurysm rupture which led them to try abciximab to prevent or mitigate thromboembolism.
"Outcome was good in 20 cases -- 61% of the total," Dr. Jones said in his oral presentation on November 30th. "Poor outcome was seen in 13 cases."