Safety of Abciximab injection during endovascular treatment of ruptured aneurysms.

Abstract

BACKGROUND AND PURPOSE:

We aimed to determine the safety of intra-arterial Abciximab injection in the management of thromboembolic complications during endovascular treatment of ruptured cerebral aneurysms.

METHODS:

In a monocentric consecutive series of endovascular treatment of 783 ruptured aneurysms, 42 (5.3%) patients received Abciximab after the aneurysm was secured. Bleeding complications were registered and dichotomized as follows: new intracranial hemorrhage and peripheral bleeding. For each patient, World Federation of Neurosurgery (WFNS) subarachnoid hemorrhage (SAH) grade, shunting, and clinical outcomes in the post-operative period and at 3-6 months were recorded.

RESULTS:

SAH WFNS grades were as follows: grade I n = 14, grade II n = 10, grade III n = 11, grade IV n = 4, grade V n = 3. Ten patients had intracranial hematoma additionally to the SAH prior to embolization. Four patients (9.5%) presented more blood on the post-embolization CT but only one suffered a new clinically relevant intracranial hemorrhage. Two patients (4.8%) experienced significant peripheral bleeding but none were associated with long-term disabilities. Fourteen patients had a shunt installed less than 24 h prior to Abciximab injection and one less than 48 h later. At 3-6-month follow-up, 31 patients (74%) achieved a modified Rankin Scale score (mRS) of 2 or less, six patients (14%) had a mRS of 3-5, three were dead (7%), and two were lost at follow-up.

CONCLUSION:

When the aneurysm is secured, intra-arterial Abciximab injection is a low complication rate treatment modality for thromboembolic events during embolization of cerebral ruptured aneurysm.

• Authors: Jean-Christophe Gentric, Joelle Brisson, André Lima Batista, Jimmy Ghostine, Jean Raymond, Daniel Roy, Alain Weill
• Journal: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences (Interv Neuroradiol) Vol. 21 Issue 3 Pg. 332-6 (Jun 2015) ISSN: 2385-2011 [Electronic] United States
• PMID: 25964436 (Publication Type: Journal Article)
• Copyright: © The Author(s) 2015.

Chemical References

• Antibodies, Monoclonal
• Immunoglobulin Fab Fragments
• Platelet Aggregation Inhibitors
• Abciximab

Topics

• Abciximab
• Adult
• Aged
• Aneurysm, Ruptured (diagnostic imaging, therapy)
• Antibodies, Monoclonal (administration & dosage)
• Cerebral Angiography
• Embolization, Therapeutic (methods)
• Endovascular Procedures (methods)
• Female
• Humans
• Immunoglobulin Fab Fragments (administration & dosage)
• Injections, Intra-Arterial
• Intracranial Aneurysm (diagnostic imaging, therapy)
• Male
• Middle Aged
• Platelet Aggregation Inhibitors (administration & dosage)
• Thromboembolism (diagnostic imaging, prevention & control)
• Treatment Outcome