Key result
Intra-arterial eptifibatide successfully dissolves intraoperative thrombi and recanalizes occluded vessels in 4 patients without bleeding.
Why the study?
Experience with intra-arterial eptifibatide for thrombolysis during aneurysm-embolization procedures with intraoperative vessel thrombosis is limited.
Does intra-arterial eptifibatide improve recanalization in patients with intraoperative vessel thrombosis during aneurysm coiling?
Case Report (n=4)
No
Does intra-arterial eptifibatide improve recanalization in patients with intraoperative vessel thrombosis during aneurysm coiling?
Intra-arterial eptifibatide administration appears to be a safe and effective rescue strategy for intraoperative vessel thrombosis during aneurysm embolization.
May support intra-arterial eptifibatide as rescue therapy in aneurysm coiling; hypothesis-generating case series leaves efficacy and safety open for prospective trials.
We report on our experience with the intra-arterial administration of eptifibatide for thrombolysis during aneurysm-embolization procedures. In 4 cases (3 stent-assisted coiling procedures and 1 with posthemorrhagic vasospasm), we noted the formation of thrombus occluding a vessel. We administered eptifibatide (10-15 mg) through a microcatheter proximal to the thrombus. The thrombus rapidly dissolved, resulting in the recanalization of the occluded vessels with no rethrombosis or hemorrhagic complications.
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Katsaridis et al. (2008) conducted a case report in Intraoperative vessel thrombosis during aneurysm coiling (n=4). Local intra-arterial eptifibatide was evaluated on Thrombus dissolution and vessel recanalization. Local intra-arterial administration of 10-15 mg eptifibatide successfully dissolved intraoperative thrombi and recanalized occluded vessels in all 4 patients without hemorrhagic complications.
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