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Titolo:
Abciximab as an adjunct to high-risk carotid or vertebrobasilar angioplasty: Preliminary experience
Autore:
Qureshi, AI; Suri, MFK; Khan, J; Fessler, RD; Guterman, LR; Hopkins, LN;
Indirizzi:
SUNY Buffalo, Sch Med & Biomed Sci, Dept Neurosurg, Buffalo, NY 14260 USA SUNY Buffalo Buffalo NY USA 14260 , Dept Neurosurg, Buffalo, NY 14260 USA SUNY Buffalo, Sch Med & Biomed Sci, Toshiba Stroke Res Ctr, Buffalo, NY 14260 USA SUNY Buffalo Buffalo NY USA 14260 a Stroke Res Ctr, Buffalo, NY 14260 USA
Titolo Testata:
NEUROSURGERY
fascicolo: 6, volume: 46, anno: 2000,
pagine: 1316 - 1324
SICI:
0148-396X(200006)46:6<1316:AAAATH>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLATELET GLYCOPROTEIN IIB/IIIA; PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; STENT PLACEMENT; BLEEDING COMPLICATIONS; CORONARY ANGIOPLASTY; BALLOON ANGIOPLASTY; ARTERY STENOSIS; HEPARIN; INTEGRINS; SURFACE;
Keywords:
abciximab; angioplasty; carotid stenosis; heparin; thrombolytic agents; vertebral stenosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Qureshi, AI Millard Fillmore Hosp, Dept Neurosurg, 3 Gates Circle, Buffalo, NY 14209 USA Millard Fillmore Hosp 3 Gates Circle Buffalo NY USA 14209 USA
Citazione:
A.I. Qureshi et al., "Abciximab as an adjunct to high-risk carotid or vertebrobasilar angioplasty: Preliminary experience", NEUROSURGER, 46(6), 2000, pp. 1316-1324

Abstract

OBJECTIVE: Abciximab, a platelet glycoprotein IIb/IIIa receptor inhibitor,has been shown to reduce the risk of ischemic events associated with coronary intervention. However, its role in neurointerventional procedures needsto be defined. We prospectively evaluated our initial experience with the use of abciximab in a series of high-risk patients undergoing carotid, basilar, or vertebral artery angioplasty. METHODS: Patients were given an intravenous abciximab bolus (0.25 mg/kg), followed by infusion (10 mu g/min) for a period ranging from 12 to 24 hours, as an adjunct to angioplasty in 20 procedures (19 patients). These patients were considered to be at high risk for thromboembolic events because of recent ischemic symptoms and/or complex lesion morphology. Before, immediately after, and 24 hours after the procedure, each patient was evaluated by a neurologist for the presence of new neurological deficits. Any bleeding or other complications during hospitalization were also recorded. Bleeding was defined as major (hemoglobin decrease >5 g/dl), minor (hemoglobin decrease 3-5 g/dl), or insignificant. RESULTS: Angioplasty was performed in the internal carotid artery (n = 13), vertebral artery (n = 4), or basilar artery (n = 2). Stents were placed across 13 lesions. In one patient, angioplasty could not be performed owing to technical difficulties; however, abciximab was administered because of extensive lesion manipulation. Intraprocedural heparin was given in 19 procedures (35-86 U/kg intravenously) and partially reversed in 6 procedures. Low-dose intra-arterial thrombolytic agents were administered in seven patients before the lesion was crossed. Two patients experienced transient neurological deficits either during (n = 1) or immediately after (n = 1) the procedure. Another patient had complete occlusion of the right vertebral arteryafter angioplasty with complete recanalization after 24 hours of abciximabinfusion. Major or minor bleeding was not observed in any patient. Insignificant bleeding was observed in eight patients. Thrombocytopenia was observed in one patient who received concomitant administration of intravenous heparin and abciximab infusion. CONCLUSION: We observed a low frequency of neurological events in high-risk patients undergoing angioplasty with or without stent placement. Abciximab seems to be a relatively safe adjunct for carotid or vertebrobasilar endovascular intervention either alone or in combination with low-dose thrombolytics. Partial reversal of intraprocedural heparin should be considered to reduce the risk of postprocedural bleeding.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 00:41:07