P.097 Safety of intrarterial reopro in thrombotic complications during coiling

Abstract

Background: Abciximab is used for the treatment of thromboembolism occuring during endovascular procedures, however the experience with intra-arterial infusion is limited. The objective is to evaluate its safety and effectiveness during coiling complications. Methods: From an aneurysm coiling database, patients treated with intra-arterial abciximab due to thrombotic complications were selected. Patient were classified either as non-ruptured aneurysm for elective coiling or presenting with subarachnoid hemorrhage. They all had preand post-procedure cerebral angiography performed at our institution as part of routine work-up. Success rate was based on recanalization seen on cerebral angiography. Complications of using abciximab were reported. Results: 35 of 441 coiling patients had a thrombotic complication. 13 of them were treated using intra-arterial infusion of abciximab. 2 patients were male, median age 59. 6 patients presented with sub-arachnoid haemorrhage. 84 % of patients had at least partial recanalization, while 38 % experienced complete recanalization of the parent vessel. 45 % of patients had complications, none severe. 2 patients had aneurysm recanalization, 3 distal migration of thrombus and 1 had haemorrhage (non ruptured aneurysm). Conclusions: Inspite of being considered a safer alternative, use of intrarterial abciximab has potential risks, including hemorrhage, distal thromboembolism and aneurysm recanalization.