Abstract | BACKGROUND AND PURPOSE: METHODS: Thromboembolic incidents during endovascular management of 515 consecutive cerebral aneurysms were observed in 48 cases (9.3%). Eight incidents were observed during embolization of incidental aneurysms (8/174; 4.6%, 95% CI: 2.0 to 8.9%). All patients underwent anticoagulation with heparin and platelet-inhibition with ASA during treatment procedure. In addition, clopidogrel orally was applied 3 days preoperatively in patients with incidental aneurysms. In case of thrombus formation, glycoprotein IIb-IIIa inhibitor abciximab was given in 42 cases. No coagulation-effective rescue treatment was conducted in 5 cases. One patient was treated with r-tPA. End points were infarction on follow-up cranial CT and the rate of intracranial hemorrhages. RESULTS: No infarcts on follow-up CT were observed after treatment with abciximab in 29/42 patients (69.0%, 95% CI: 52.9 to 82.4%). No coagulant rescue therapy was applied in 5 patients because of a small nonocclusive thrombus or good collateral blood supply, showing consecutive infarction on follow-up CT in 3 cases as did the 1 patient treated with r-tPA. No periprocedural bleedings or rebleedings were observed in any case. CONCLUSIONS:
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Authors | Thorsten Ries, Susanne Siemonsen, Ulrich Grzyska, Hermann Zeumer, Jens Fiehler |
Journal | Stroke
(Stroke)
Vol. 40
Issue 5
Pg. 1750-7
(May 2009)
ISSN: 1524-4628 [Electronic] United States |
PMID | 19299631
(Publication Type: Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Immunoglobulin Fab Fragments
- Platelet Aggregation Inhibitors
- Platelet Glycoprotein GPIIb-IIIa Complex
- Abciximab
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Topics |
- Abciximab
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal
(therapeutic use)
- Blood Coagulation
- Cerebral Hemorrhage
(chemically induced, epidemiology)
- Cerebral Infarction
(etiology)
- Child
- Data Interpretation, Statistical
- Embolization, Therapeutic
(adverse effects)
- Female
- Humans
- Immunoglobulin Fab Fragments
(therapeutic use)
- Intracranial Aneurysm
(drug therapy)
- Male
- Middle Aged
- Platelet Aggregation Inhibitors
(therapeutic use)
- Platelet Glycoprotein GPIIb-IIIa Complex
(antagonists & inhibitors)
- Thromboembolism
(drug therapy, etiology)
- Tomography, X-Ray Computed
- Treatment Outcome
- Vasospasm, Intracranial
(etiology)
- Young Adult
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