Abciximab Does Not Prevent Ischemic Lesions Related to Cerebral Angiography: A Randomized Placebo-Controlled Trial

Brockmann, Carolin; Hoefer, Thomas; Diepers, Michael; Neumaier-Probst, Eva; Noelte, Ingo; Brockmann, Marc-Alexander; Weiß, Christel; Groden, Christoph; Scharf, Johann

doi:10.1159/000323219

Cited by 11 publications

(6 citation statements)

References 42 publications

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“…Similar lesions were also observed with the injection of PBS at a rate of 0.16ml/min 13 . T2 abnormalities were similar to those observed in patients who undergo routine cerebral angiography 23, 24 .…”

Section: Safety Of Ia Injection After Strokesupporting

confidence: 78%

Intra-Arterial Delivery of Cell Therapies for Stroke

Guzman

Janowski

Walczak

2018

Stroke

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Section: Safety Of Ia Injection After Strokesupporting

confidence: 78%

Intra-Arterial Delivery of Cell Therapies for Stroke

Guzman

Janowski

Walczak

2018

Stroke

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“…Diffusion-weighted MRI (DWI) reveals a relatively high rate of ischemic events, most of which do not cause overt neurological deficits; therefore, it is well known that silent microembolism or cerebral ischemia are much more frequent than actual clinical events. DWI studies have indicated that 10–40% of patients have clinically silent embolism during such procedures [3,4,5]. …”

Section: Introductionmentioning

confidence: 99%

Post-Interventional Microembolism: Cortical Border Zone Is a Preferential Site for Ischemia

Park

Chung²,

Kim³

et al. 2011

Cerebrovasc Dis

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Background: Previous diffusion-weighted MRI (DWI) studies have indicated that 10–40% of patients have silent embolism during neurointerventional procedures. However, lesion patterns of the embolisms have not been adequately investigated. Methods: DWI was taken within 7 days before and 48 h after cerebral angioplasty and stent procedures. New lesions on the follow-up DWI were analyzed in the non-treated arterial territories. Based on the arterial territories, supratentorial lesions were classified into cortical lesions and subcortical lesions. Cortical lesions were subdivided into cortical border zone and cortical proper lesions. Subcortical lesions were divided into deep perforator and internal border zone lesions. Infratentorial lesions were divided into brainstem and cerebellar lesions. Results: 72 patients were included in this study. There were 223 new DWI lesions (1–23 lesions) in the non-treated arterial territories of 37 patients. There were 154 cortical lesions, 45 cerebellar lesions, 21 subcortical lesions and 3 brainstem lesions. Analysis of the distribution pattern of cortical lesions showed that 88 of 154 lesions were located at the cortical border zone. Of the subcortical lesions, 13 of 21 lesions were located at the internal border zone area, within the corona radiata and centrum ovale. Only 4 lesions were located at the deep perforator territory. Infratentorial lesions were mostly located at the cerebellar hemisphere (45/48). Most lesions were tiny infarcts (<5 mm diameter); 7 of 223 lesions were >10 mm in diameter. Conclusions: Interventional-angiography-related microembolisms mostly lodge in the cerebral cortical border zone area and cerebellar hemisphere. Microembolisms to the deep perforating artery territory are distinctly rare.

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“…1 The plausible embolic sources of SECI, suggested from the previous studies, are thrombus formed from the catheter by platelet activation, dislodgement of the atheroma from the aortic arch by mechanical stress, 13 and air embolism. 15 Activation of the platelets by catheterization was revealed by previous studies using platelet flow cytometry, 16 and the platelet membrane activation markers were predictive for increased risk of ischemic events after catheterization. 17 In our study, the factors related to atherosclerotic burden (atherosclerosis score and the severity of coronary artery disease) or mechanical stress (number and size of the catheter used, total procedure time, and fluoroscopy time) did not differ by the occurrence of SECI.…”

Section: Discussionmentioning

confidence: 93%

Insufficient Platelet Inhibition Is Related to Silent Embolic Cerebral Infarctions After Coronary Angiography

Kim

Lee

Park

et al. 2012

Stroke

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Background and Purpose-Considering that insufficient platelet inhibition is related to thrombotic complications after coronary angiography, we hypothesized that the extent of platelet inhibition by antiplatelet agents is related to the occurrence of silent embolic cerebral infarction (SECI) after coronary angiography. Methods-Among the patients scheduled for coronary artery bypass surgery, we retrospectively analyzed the location of SECI on diffusion-weighted imaging of 272 patients, which was performed after coronary angiography, as a presurgical evaluation in Phase 1 study. In Phase 2 study, we have prospectively recruited 102 patients to compare the extent of platelet inhibition measured by the VerifyNow system among patients with and without SECI. Results-SECI is observed in 45 patients (16.5%) in Phase 1 and 17 (16.7%) in Phase 2. The lesions were slightly more frequent in the right hemisphere. In the Phase 2 study, aspirin reaction units and P 2 Y 12 reaction units were higher in the patients with SECI than those without (aspirin reaction units: 490Ϯ72 versus 446Ϯ53, Pϭ0.03; P 2 Y 12 reaction units: 352Ϯ65 versus 300Ϯ77, Pϭ0.009). The incidence of SECI increased with the number of resistant antiplatelets; resistance to both antiplatelet agent (50%), resistance to 1 antiplatelet agent (22%), and no resistance (4%; Pϭ0.023).From the result of logistic regression, higher aspirin reaction units, white blood cell count, low hemoglobin, and nonresponsiveness to antiplatelet agents were independent risk factors. Conclusions-Insufficient platelet inhibition after administration of antiplatelet agents is related with SECI appearing after coronary angiography. (Stroke. 2012;43:727-732.)

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Abciximab Does Not Prevent Ischemic Lesions Related to Cerebral Angiography: A Randomized Placebo-Controlled Trial

Cited by 11 publications

References 42 publications

Intra-Arterial Delivery of Cell Therapies for Stroke

Intra-Arterial Delivery of Cell Therapies for Stroke

Post-Interventional Microembolism: Cortical Border Zone Is a Preferential Site for Ischemia

Insufficient Platelet Inhibition Is Related to Silent Embolic Cerebral Infarctions After Coronary Angiography

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