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

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.