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AJNR - American Journal of Neuroradiology

Published ahead of print on September 10, 2008
doi: 10.3174/ajnr.A1253

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American Journal of Neuroradiology 29:1925-1929, November-December 2008
© 2008 American Society of Neuroradiology

INTERVENTIONAL

Abciximab for Treatment of Thromboembolic Complications during Endovascular Coiling of Intracranial Aneurysms

R.G. Jones^a, I. Davagnanam^a, S. Colley^a, R.J. West^a and D.A. Yates^a

^a From the Department of Interventional Radiology, University Hospital Birmingham, Queen Elizabeth Medical Centre, Birmingham, UK

Please address correspondence to Robert Jones, MD, Department of Interventional Radiology, University Hospital Birmingham, Queen Elizabeth Medical Centre, Birmingham B15 2TH, UK; e-mail: jonesradiology{at}gmail.com

BACKGROUND AND PURPOSE: Thromboembolism is a recognized complication occurring during endovascular coil embolization of intracranial aneurysms. Recently, there has been much interest in glycoprotein IIb/IIIa inhibitors to treat such complications, but the evidence is limited. We reviewed our use of one such agent, abciximab, which we commonly administer and believe to be a safe and suitable rescue agent in this setting.

MATERIALS AND METHODS: We retrospectively reviewed cases in which abciximab was administered in our institution between 2001 and 2007. Clinical outcome was assessed by the modified Rankin Scale (mRS) at 6 months. Good outcome was defined as no significant clinical sequelae compared with baseline status or clinical improvement (mRS < 2). Poor outcome was defined as no resolution of a new clinical deficit that developed postprocedure at 6 months (mRS > 2). Angiographic appearance of thromboembolic phenomena and posttreatment outcome was assessed with the Thrombolysis in Myocardial Infarction (TIMI) scale.

RESULTS: Thirty-eight patients were included, with good outcome observed in 30 (79%) and poor outcome in 8 (21%) patients. Angiographic improvement based on TIMI scoring was seen in 24 (63%) patients, and no improvement was seen in 14 (37%). In 4 patients (11%), good outcome was obtained at 6 months despite no angiographic improvement on TIMI. No cases of intracranial rebleed or additional neurologic deficit following administration of abciximab were encountered.

CONCLUSION: In this small retrospective series, abciximab was safe and effective when used as a rescue agent for thromboembolic complications encountered during coiling of intracerebral aneurysms.