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Abciximab use safe during carotid stenting

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – The platelet glycoprotein IIb/IIIa receptor antagonist, abciximab, can be used during carotid stenting with no increased risk of intracranial hemorrhage, according to a report published in the October issue of Stroke. The findings suggest that abciximab reduces the risk of ischemic complications.

Dr. Jay S. Yadav and colleagues, from the Cleveland Clinic Foundation, assessed the outcomes of 151 high-risk patients with carotid stenosis who underwent carotid stenting. Of these patients, 128 received abciximab adjuvant therapy and 23 did not.

Abciximab-treated patients received a heparin bolus followed by abciximab before the stenotic lesion was crossed. An abciximab infusion was maintained for 12 hours after the procedure.

Two (8%) of the patients in the control group experienced ischemic adverse events compared with two (1.6%) of patients in the abciximab group (p = 0.05). Furthermore, the two events that occurred in the abciximab group, one minor stroke and one retinal infarction, were less severe than the two events in the control group, one major stroke and one neurologic-related death.

With the exception of one abciximab-treated patient who presented with intracranial hemorrhage on 30-day follow-up, no other major bleeding complications occurred, the authors note.

The current study was designed to assess the safety of abciximab during carotid stenting, but the results also suggest that it is efficacious in reducing the risk of ischemic complications, the researchers state. However, the adverse ischemic event rate was too low to permit multivariate analysis.

Randomized trials are needed to establish the efficacy of abciximab therapy and to determine the relative ischemic risk reduction it confers, Dr. Yadav's team concludes.

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