Intracoronary Administration of Abciximab During Percutaneous Coronary Interventions: Should This Be the Routine and Preferred Approach?

The authors have had experience with administering abciximab as an intracoronary bolus in 96 high-risk patients undergoing percutaneous coronary interventions, specifically in situations in which there was anticipation of a high embolic load from thrombus/plaque burden at the site of the culprit lesion, saphenous vein graft culprit lesion, threatened abrupt closure, developing slow-flow, or no-reflow phenomena with distal embolization. Our uncontrolled data basically substantiate the safety of intracoronary administration of abciximab. The data summarizing the potential superiority of this method of administration of the drug and the likely mechanisms of this effect are summarized. These incite a need for reevaluation of the method of administration of the drug, especially in high-risk percutaneous coronary interventions cases.