Article Figures & Data
Figures
- Fig 1.
Illustrative case 1.
A, Right internal carotid artery angiogram, oblique projection, unsubtracted, shows a coil loop protruding into the parent vessel.
B, Right internal carotid artery angiogram, oblique projection, subtracted view, shows a filling defect about the coil loop, indicating thrombus formation. Note the decreased antegrade flow into the supraclinoid internal carotid artery.
C, Right internal carotid artery angiogram obtained via a microcatheter injection. The image clearly shows the filling defects about the protruded coil loop and more distally.
D, After a local, low-dose (2-mg), intra-arterial infusion of abciximab through the microcatheter, thrombus dissolution is documented without evidence of distal thromboembolism.
- Fig 2.
Illustrative case 2.
A, Nonenhanced CT scan shows subarachnoid hemorrhage and ventricular prominence.
B, Right internal carotid artery angiogram, frontal projection, shows a heart-shaped anterior communicating artery aneurysm pointing inferiorly, with filling of both anterior cerebral arteries through the anterior communicating artery.
C, Right internal carotid artery angiogram, frontal projection, shows frank extravasation of contrast material during deployment of the first coil.
D, Right internal carotid artery angiogram, frontal projection, obtained after coil placement inf the aneurysm shows no further extravasation of contrast agent. However, both anterior cerebral arteries no longer fill.
E, Right anterior cerebral artery angiogram, with a manual injection via a microcatheter, lateral projection, shows a paucity of branch filling consistent with extensive thromboembolism.
F, Right anterior cerebral artery angiogram, with a manual injection via a microcatheter, lateral projection, after local low-dose intra-arterial infusion of 5 mg of abciximab through the microcatheter, shows recanalization of the anterior cerebral artery branches.
G, Right internal carotid artery angiogram, frontal projection, after aneurysm rupture, aneurysm coil placement, and thrombolysis with intra-arterial ReoPro shows no filling of the anterior communicating artery aneurysm and normal filling of both anterior cerebral arteries.
Tables
Summary of anatomic and clinical results
Patient/Age (y)/Sex Location Size (mm) Neck (mm) Ruptured Embolics ACT (seconds) Abciximab Hunt-Hess Grade Angiographic Outcome 1/71/F Anterior communicating artery 5 × 4 3 Yes GDC, Matrix 327 Intra-arterial 5 mg IV Recanalization, contrast-agent extravasation 2/48/M L pericallosal, L parietal arteriovenous malformation 7 × 5 4 No GDC, glue 270 Intra-arterial 2 mg NA Recanalization 3/56/F R middle cerebral artery bifurcation 7 × 6 6 Yes GDC 340 Intra-arterial 5 mg, 17-mg intravenous bolus II Recanalization 4/45/F R superior hypophyseal 7 × 6 4 No DCS, Matrix 231 Intra-arterial 2 mg, 3-mg intravenous bolus NA Recanalization 5/47/M L middle cerebral artery bifurcation 8 × 7 5 No GDC, Microplex 315 Intra-arterial 5 mg NA No recanalization 6/48/F R posterior communicating artery 7 × 7 3 Yes GDC 256 Intra-arterial 5 mg I Partial recanalization 7/50/F Anterior communicating artery 5 × 4 3 Yes GDC 257 Intra-arterial 5 mg I Recanalization, contrast-agent extravasation Note.—None of the patients had new neurologic deficits after the procedure. NA indicates not applicable.
In this issue
Jump to section
Related Articles
Cited By...
- Use of Platelet Function Testing Before Pipeline Embolization Device Placement: A Multicenter Cohort Study
- Ischemic Stroke After Treatment of Intraprocedural Thrombosis During Stent-Assisted Coiling and Flow Diversion
- Intra-arterial versus intravenous abciximab therapy for thromboembolic complications of neuroendovascular procedures: case review and meta-analysis
- Periprocedural complications associated with endovascular treatment of intracranial aneurysms in 1764 cases
- Rescue Treatment of Thromboembolic Complications during Endovascular Treatment of Cerebral Aneurysms: A Meta-Analysis
- Intra-Arterial Infusion of a Glycoprotein IIb/IIIa Antagonist for the Treatment of Thromboembolism During Coil Embolization of Intracranial Aneurysm: A Comparison of Abciximab and Tirofiban
- Rescue Treatment of Thromboembolic Complications During Endovascular Treatment of Cerebral Aneurysms
- A checklist for cerebral aneurysm embolization complications
- Intra-arterial abciximab for the treatment of thrombus formation during coil embolization of intracranial aneurysms
- Abciximab Is a Safe Rescue Therapy in Thromboembolic Events Complicating Cerebral Aneurysm Coil Embolization: Single Center Experience in 42 Cases and Review of the Literature
- Intravenous Administration of Acetylsalicylic Acid During Endovascular Treatment of Cerebral Aneurysms Reduces the Rate of Thromboembolic Events