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Vascular complications after percutaneous coronary interventions using abciximab (Reopro ): prospective evaluation
1Department of Cardiology, University Medical Center, Zaloska 7, 1000, Ljubljana, Slovenia. igor.kranjec@kclj.si
Insights
Vascular access site complications (VASC) were more common in patients receiving abciximab during percutaneous transluminal coronary angioplasty (PTCA). Refined techniques and Doppler color flow imaging are recommended to minimize these risks.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure.
- Vascular access site complications (VASC) are potential risks.
- Abciximab is an antiplatelet drug used adjunctively in PTCA.
Purpose of the Study:
- To determine the incidence of VASC in patients undergoing PTCA with or without abciximab.
- To identify factors associated with VASC.
- To assess the consequences of VASC in this patient population.
Main Methods:
- A comparative study involving 120 patients undergoing PTCA.
- Patients were divided into two groups: with abciximab (n=60) and without (n=60).
- VASC were assessed within 24 hours using physical examination and Doppler color flow imaging (DCFI).
Main Results:
- VASC occurred more frequently in the abciximab group (30% vs. 10%, p=0.006).
- Multivariate analysis identified abciximab administration, platelet fall >40%, and double-wall puncture as significant risk factors for VASC.
- Vascular repair was required in 10% of patients treated with abciximab.
Conclusions:
- Adjunctive abciximab may increase the rate of VASC following PTCA.
- Employing refined catheterization techniques is advised to reduce VASC.
- DCFI is recommended for patients with abnormal groin findings or significant platelet reduction post-PTCA.
Unlabelled:
The aim of our study was to assess the incidence and consequences of vascular access site complications (VASC) associated with abciximab treatment in patients undergoing percutaneous transluminal coronary angioplasty (PTCA).
Patients And Methods:
Between July 1996 and November 1997, 120 patients underwent PTCA with adjunctive abciximab (n = 60) or without it (n = 60). VASC were assessed within 24 hours of PTCA completion by physical examination and Doppler color flow imaging (DCFI) of the groin.
Results:
A total of 24 VASC were observed mostly in abciximab patients (30% vs. 10%; p = 0.006) and only half of them were suspected on physical examination. Abciximab administration [odds ratio (OR) = 3.1; 95% confidence interval (CI) = 1.03Eth 9.0; p = 0.001], platelet fall > 40% (OR = 5.0; CI = 1. 03Eth 24.6; p = 0.045), and double-wall femoral artery puncture (OR = 5.3; CI = 1.9Eth 14.7; p = 0.001) carried a high probability of VASC after multivariate analysis. Vascular repair was needed in 10% of abciximab patients.
Conclusions:
Aggressive antiplatelet drugs adjunctive to the anticoagulation treatment may result in an increased rate of VASC after PTCA. The use of refined catheterization techniques is advised to avoid VASC associated with abciximab administration. DCFI is recommended in the patients with abnormal groin finding or significant platelet fall after PTCA.