Intra-arterial infusion of a glycoprotein IIb/IIIa antagonist for the treatment of thromboembolism during coil embolization of intracranial aneurysm: a comparison of abciximab and tirofiban.

Abstract

BACKGROUND AND PURPOSE:

Abciximab and tirofiban are commonly used for the treatment of thromboembolisms that form during coiling of intracranial aneurysms; however, it is not known which of these inhibitors is safer and more effective. We report the safety and the recanalization rates for intra-arterial abciximab and intra-arterial tirofiban infusion for the treatment of thromboembolisms that form during coiling.

MATERIALS AND METHODS:

Between March 2004 and April 2011, 346 intracranial aneurysms were treated with coiling. Thromboembolisms developed in 22 of these patients and were treated by use of intra-arterial tirofiban (n = 11) or abciximab (n = 11) infusion.

RESULTS:

In the abciximab group, the thromboembolisms were completely (n = 1) or partially (n = 7) resolved in 8 cases (72.7%) at the time of the final control angiography. Complete (n = 9) or partial (n = 2) resolution was achieved in all cases at the time of follow-up angiography (<3 days after the procedure). In the tirofiban group, thromboembolisms were completely (n = 4) or partially (n = 6) resolved in 10 cases (90.9%) at the time of the final control angiography. Complete (n = 9) or partial (n = 2) resolution was observed in all cases at the time of the follow-up angiography. There were no statistically significant differences between the 2 groups with respect to thrombus resolution (final angiography, P = .311; follow-up angiography, P = .707). No hemorrhagic complications developed in either group.

CONCLUSIONS:

These results suggest that tirofiban is more effective than abciximab for the immediate resolution of thromboembolisms, with no statistical significance. Both intra-arterial tirofiban and abciximab exhibited similar safety and recanalization rates.

• Authors: H W Jeong, S-C Jin
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 34 Issue 8 Pg. 1621-5 (Aug 2013) ISSN: 1936-959X [Electronic] United States
• PMID: 23660289 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Anticoagulants
• Fibrinolytic Agents
• Immunoglobulin Fab Fragments
• Platelet Glycoprotein GPIIb-IIIa Complex
• Tyrosine
• Tirofiban
• Abciximab

Topics

• Abciximab
• Adult
• Antibodies, Monoclonal (administration & dosage)
• Anticoagulants (administration & dosage)
• Female
• Fibrinolytic Agents (administration & dosage)
• Humans
• Immunoglobulin Fab Fragments (administration & dosage)
• Infusions, Intra-Arterial
• Intracranial Aneurysm (diagnostic imaging, surgery, therapy)
• Intracranial Thrombosis (diagnostic imaging, etiology, prevention & control)
• Male
• Mechanical Thrombolysis (adverse effects)
• Middle Aged
• Platelet Glycoprotein GPIIb-IIIa Complex (antagonists & inhibitors)
• Radiography
• Tirofiban
• Treatment Outcome
• Tyrosine (administration & dosage, analogs & derivatives)