Adjuvant use of abciximab for balloon angioplasty of symptomatic middle cerebral artery stenosis

Abstract

Purpose: To evaluate the safety of adjuvant intravenous use of abciximab in balloon angioplasty for symptomatic middle cerebral artery stenosis.

Material and methods: Seven patients with symptomatic stenosis at the main trunk (n=5), or proximal post-trifurcation portion (n=2) of the middle cerebral artery, were enrolled in the study. A bolus dose of abciximab (0.15 mg/kg) was given intravenously immediately before the procedure. The immediate morphologic results as well as the presence of hyperacute thrombosis or hemorrhage after angioplasty were evaluated. Clinical evaluation was performed 1 day and 1 month following angioplasty. Oral antiplatelets were administered during the follow-up period. Follow-up angiography was performed after 7 to 14 (mean 10.4) months. Stenosis of a vessel greater than 50% was considered as restenosis.

Results: The procedure was technically successful in all patients. Immediate residual stenosis was insignificant in 4 and mild (less than 50%) in 3 patients. There was no evidence of intimal dissection. Mild gum bleeding was noted in two patients. All study patients were clinically stable at follow-up without newly developed neurological abnormality even though there was one case of occlusion and one case of restenosis on follow-up angiography. Angiographic patency rate was 71%.

Conclusion: In performing proximal middle cerebral artery balloon angioplasty, abciximab may be safely used to prevent acute thrombosis. The mid-term patency of the vessels was also acceptable.