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Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms

Abstract

Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization.  More>>
Authors:
Cho, Young Dae, E-mail: aronnn@naver.com; [1]  Lee, Jong Young, E-mail: gen78@naver.com; [2]  Seo, Jung Hwa, E-mail: jhseo34@gmail.com; [2]  Kang, Hyun-Seung; [3]  Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr; [3]  Jung, Keun Hwa, E-mail: jungkh@gmail.com; [4]  Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of); Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)]
  1. Department of Radiology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 425 Sindaebang-dong, Dongjak-gu, Seoul 156-707 (Korea, Republic of)
  2. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)
  3. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)
  4. Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)
Publication Date:
Oct 15, 2012
Product Type:
Journal Article
Resource Relation:
Journal Name: European Journal of Radiology; Journal Volume: 81; Journal Issue: 10; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: Cuba
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CEREBRAL ARTERIES; DOSES; EMBOLI; HAZARDS; HEMORRHAGE; INFUSION; MALES; PATIENTS; RUPTURES; THROMBOSIS
OSTI ID:
22222934
Country of Origin:
Netherlands
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0720-048X; CODEN: EJRADR; Other: PII: S0720-048X(11)00801-1; TRN: NL13R1046043889
Availability:
Available from http://dx.doi.org/10.1016/j.ejrad.2011.11.023
Submitting Site:
NLN
Size:
page(s) 2833-2838
Announcement Date:
May 01, 2014

Citation Formats

Cho, Young Dae, E-mail: aronnn@naver.com, Lee, Jong Young, E-mail: gen78@naver.com, Seo, Jung Hwa, E-mail: jhseo34@gmail.com, Kang, Hyun-Seung, Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr, Jung, Keun Hwa, E-mail: jungkh@gmail.com, Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of), and Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)]. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms. Netherlands: N. p., 2012. Web. doi:10.1016/J.EJRAD.2011.11.023.
Cho, Young Dae, E-mail: aronnn@naver.com, Lee, Jong Young, E-mail: gen78@naver.com, Seo, Jung Hwa, E-mail: jhseo34@gmail.com, Kang, Hyun-Seung, Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr, Jung, Keun Hwa, E-mail: jungkh@gmail.com, Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of), & Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)]. Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms. Netherlands. https://doi.org/10.1016/J.EJRAD.2011.11.023
Cho, Young Dae, E-mail: aronnn@naver.com, Lee, Jong Young, E-mail: gen78@naver.com, Seo, Jung Hwa, E-mail: jhseo34@gmail.com, Kang, Hyun-Seung, Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr, Jung, Keun Hwa, E-mail: jungkh@gmail.com, Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of), and Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)]. 2012. "Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms." Netherlands. https://doi.org/10.1016/J.EJRAD.2011.11.023.
@misc{etde_22222934,
title = {Intra-arterial tirofiban infusion for thromboembolic complication during coil embolization of ruptured intracranial aneurysms}
author = {Cho, Young Dae, E-mail: aronnn@naver.com, Lee, Jong Young, E-mail: gen78@naver.com, Seo, Jung Hwa, E-mail: jhseo34@gmail.com, Kang, Hyun-Seung, Kim, Jeong Eun, E-mail: eunkim@snu.ac.kr, Jung, Keun Hwa, E-mail: jungkh@gmail.com, Han, Moon Hee, E-mail: hanmh@snuh.org [Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of), and Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul 110-744 (Korea, Republic of)]}
abstractNote = {Introduction: Intra-arterial (IA) thrombolytic intervention for acute thrombosis has been challenged due to the risk of bleeding during the endovascular treatment of ruptured aneurysms. We present the results of IA tirofiban infusion for thromboembolic complications during coil embolization in patients with ruptured intracranial aneurysms. Methods: Thromboembolic events requiring thrombolytic intervention occurred in 39 (10.5%) cases during coil embolization of 372 consecutive ruptured intracranial aneurysms. Maximal aneurysm diameters of 39 patients (mean age, 54.7 ± 13.2 years; 23 female, 16 male) ranged from 2.1 to 13.1 mm (mean, 6.6 ± 3.0 mm). The anterior communicating artery was the most common site (n = 13), followed by the middle cerebral artery (n = 9) and the posterior communicating artery (n = 7). In this series, we used intracranial stents in 10 patients during the procedure. Superselective IA tirofiban infusion through a microcatheter was performed to resolve thrombi and emboli. We assessed the efficacy and safety of IA tirofiban infusion in patients with ruptured aneurysms. Results: Intraarterially administered tirofiban doses ranged from 0.25 to 1.25 mg (mean, 0.71 ± 0.26 mg). Effective thrombolysis or recanalization was achieved in 34 patients (87.2%), and three patients (7.7%) suffered distal migration of clots with partial recanalization. The rest (5.1%) had no recanalization. Nonconsequent intracerebral hemorrhage occurred in two patients (5.1%) after the procedure. Thromboemboli-related cerebral infarction developed in eight patients, and only two patients remained infarction related disabilities. Conclusion: IA tirofiban infusion seems to be efficacious and safe for thrombolysis during coil embolization in patients with ruptured intracranial aneurysms.}
doi = {10.1016/J.EJRAD.2011.11.023}
journal = []
issue = {10}
volume = {81}
journal type = {AC}
place = {Netherlands}
year = {2012}
month = {Oct}
}