J Korean Radiol Soc.
2004 Jul;51(1):19-26. 10.3348/jkrs.2004.51.1.19.
Effectiveness of Intra-arterially Administered Abciximab as a Rescue Method for Intracranial Acute In-Stent Thrombosis
- Affiliations
-
- 1Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Korea.
- 2Department of Diagnostic Radiology, Anyang Metro-Hospital, Korea.
- 3Department of Diagnostic Radiology, Chosun University Hospital, Chosun University School of Medicine, Korea.
- KMID: 2199774
- DOI: http://doi.org/10.3348/jkrs.2004.51.1.19
Abstract
- PURPOSE: To determine the efficacy and safety of the intra-arterial administration of glycoprotein IIb/IIIa inhibitor for resolving acute in-stent thrombosis complicating stent-assisted angioplasty for intracranial atherosclerosis.
MATERIALS AND METHODS
We placed 60 therapeutic stents (24 internal carotid arteries, 20 vertebrobasilar arteries, and 16 middle cerebral arteries) for the treatment of symptomatic intracranial atherosclerosis. Among the 60 stenting procedures, acute in-stent thrombosis occurred after stent deployment in 11 cases (18.3%). As the method of dissolving the acute in-stent thrombosis, 2 mg abciximab were intra-arterially administered through a guiding catheter. Angiography was then performed after 10-20 minutes to identify any undissolved material resulting from the thrombosis. If the thrombosis was still observed on the angiography, an additional 2 mg of abciximab were administered, and this procedure was repeated until complete thrombolysis was obtained. Post-procedural non-enhanced brain CT was performed for the evaluation of possible hemorrhagic complications.
RESULTS
After each intra-arterial administration of 2 mg of abciximab, successive angiographies showed the process of resolution of the acute thrombosis. All 11 acute in-stent thromboses were completely dissolved within 40 to 80 minutes. The total dosage of infused abciximab was 8 mg in one case, 10 mg in eight cases, and 16 mg in two cases. Post-procedural non-enhanced brain CT revealed no hemorrhagic complications.
CONCLUSION
The intra-arterial administration of abciximab can be a safe and effective therapeutic method for acute in-stent thrombosis complicating the stenting of stenotic intracranial arteries.
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