Abciximab in Patients with Ruptured Intracranial Aneurysms
Richard I. Aviva,
Richard O’Neillb,
Maneesh C. Patelb and
Iain R. Colquhounb
a Neuroradiology Section, Imaging Department, Charing Cross Hospital, London, United Kingdom
b Division of Neuroradiology, Department of Radiology, Sunnybrook Hospital, Toronto, Ontario, Canada
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FIG 1. Anteroposterior oblique views, selective right ICA injection.
A, Right PCOM aneurysm in association with fetal-type PCA after the insertion of six coils. Image shows minor projection of coils into the terminal ICA (arrow), which demonstrates spasm. Contrast material irregularly fills the proximal ACA, with nonvisualization of the distal ACA. These findings are consistent with thrombus (arrowhead).
B, Immediately after the intravenous injection of abciximab 20 mg, the A1 segment of the ACA (arrowhead) is completely recanalized. Minor filling defect in the proximal A2 (arrow) dissipated shortly afterward.
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FIG 2. Anteroposterior views.
A and B, Selective right ICA injection after the insertion of three coils. Before abciximab treatment (A), thrombus is seen at the neck of the aneurysm (arrowhead) and in the proximal right A2 segment of the right anterior cerebral artery (arrow). After abciximab (B), improvement in both is noted.
C and D, Selective injection after the insertion of five coils and aneurysm rupture. In C, thrombus (arrow) is present in the distal A1 segment and ACOM, with adjacent extravasation of contrast material (arrowhead). After heparin reversal, repeat angiogram in D demonstrates aneurysm occlusion, cessation of extravasation, and absence of thrombus, but marked vasospasm is present.
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