Abciximab for thrombolysis during intracranial aneurysm coiling

Area of Science:

• Interventional Neuroradiology
• Vascular Surgery
• Pharmacology

Background:

• Thrombotic events are a significant complication of endovascular aneurysm treatment.
• These events negatively impact patient outcomes.
• Identifying risk factors and effective treatments is crucial.

Purpose of the Study:

• To evaluate risk factors for thrombus formation during endovascular aneurysm repair.
• To assess the efficacy and safety of abciximab for thrombus dissolution.
• To determine the clinical and angiographic outcomes of abciximab use.

Main Methods:

• Retrospective analysis of 63 patients treated with abciximab (intra-arterial or intravenous) during or after intracranial aneurysm coil embolization (2000-2007).
• Assessment of risk factors for clot formation.
• Evaluation of angiographic and clinical outcomes, including recanalization rates and complications.

Main Results:

• Abciximab demonstrated an intra-procedural recanalization rate of 68.3%.
• Thromboembolic complications were more common in Acom and basilar artery aneurysms.
• Two treatment-related deaths occurred due to intracranial hemorrhage into pre-existing infarcts; two patients had groin hematomas.

Conclusions:

• Abciximab is effective and safe for thrombolysis in endovascular intracranial aneurysm treatment.
• Its use is particularly beneficial when preexisting ischemic stroke is absent.
• The study highlights specific aneurysm locations associated with higher thromboembolic risk.