Short- and Long-Term Results of Abciximab Versus Aspirin in Conjunction with Thrombolysis for Patients with Peripheral Occlusive Arterial Disease and Arterial Thrombosis

Schweizer, Johannes; Kirch, Wilhelm; Koch, Reiner; Müller, A.; Hellner, Grit; Forkmann, Lutz

doi:10.1177/000331970005101104

Cited by 28 publications

(9 citation statements)

References 19 publications

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“…A small study by Schweizer et al [50] randomized 84 patients to 5 mg rt-PA intravenously and 500 IU heparin/hr along with either 500 mg aspirin or a bolus of 0.25 mg/kg abciximab followed by 10 g/min over 12 hr with 250 IU heparin/hr. Primary efficacy criteria included the number of rehospitalizations, reinterventions, and amputations during the following 6 months.…”

Section: Acute Critical Limb Ischemiamentioning

confidence: 99%

“…Secondary peripheral occlusive arterial disease variables became highly significant vs. aspirin (P Ͻ 0.001 or greater) at 3 and 6 months after treatment. Thus, adjunctive use of abciximab reduced the rates of rehospitalization, reinterventions, and amputations vs. the results with the use of aspirin [50]. In the PROMPT trial [51], 70 patients with peripheral arterial occlusion of less than 6 weeks' duration were randomized to urokinase plus abciximab vs. urokinase plus placebo.…”

Section: Acute Critical Limb Ischemiamentioning

confidence: 99%

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Noncardiac applications of glycoprotein IIb/IIIa inhibitors

Almeda

Schaer

2004

Cathet Cardio Intervent

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Platelet activation and aggregation have become increasingly recognized as the primary processes involved in the cascade that leads to thrombus formation in atherosclerotic vascular disease. Glycoprotein IIb/IIIa receptor inhibitors (GPI) favorably impact thrombus formation and distal embolization by inhibiting the final common pathway of platelet aggregation. Glycoprotein IIb/IIIa inhibitors have been used effectively in a wide variety of clinical scenarios including unstable angina, non-ST segment elevation myocardial infarction, ST segment elevation myocardial infarction, and low and high risk percutaneous coronary interventions with and without intracoronary stenting, however there is limited data regarding the use of these potent antiplatelet agents in the setting of extracardiac vascular disease. This article will review the non-cardiac applications of glycoprotein IIb/IIIa inhibitors in the setting of acute ischemic stroke, carotid and vertebral angioplasty and stenting, acute critical limb ischemia, and percutaneous interventions in peripheral arterial occlusive disease.

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Section: Acute Critical Limb Ischemiamentioning

confidence: 99%

Section: Acute Critical Limb Ischemiamentioning

confidence: 99%

Noncardiac applications of glycoprotein IIb/IIIa inhibitors

Almeda

Schaer

2004

Cathet Cardio Intervent

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“…Although proof of a direct benefit for aspirin therapy in patients with intermittent claudication (IC) is lacking, 1,2 the increased cardiovascular morbidity and mortality in this patient group is widely regarded as a justification for antiplatelet therapy 3,4 . Aspirin treatment in patients with carotid artery disease is well established 5–7 . Meta‐analysis of randomized trials has shown a 25% reduction in vascular end‐points in patients at high risk of vascular complications and has indicated a 48% reduction in vascular graft and arterial occlusion 5,6 .…”

Section: Introductionmentioning

confidence: 99%

“…3,4 Aspirin treatment in patients with carotid artery disease is well established. [5][6][7] Meta-analysis of randomized trials has shown a 25% reduction in vascular end-points in patients at high risk of vascular complications and has indicated a 48% reduction in vascular graft and arterial occlusion. 5,6 Reducing risk of recurrent vascular events is offset by a dose-dependent increased risk of bleeding.…”

Section: Introductionmentioning

confidence: 99%

Point of Care Testing of Aspirin Resistance in Patients With Vascular Disease

Wong

Ward²,

Appleberg³

et al. 2006

ANZ Journal of Surgery

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“…In a preliminary investigation it was demonstrated that after 6 months patients who receive abciximab benefited in terms of the rehospitalization rate and amputation rate compared to patients treated with aspirin alone. 4 The results raise the question as to whether other GP IIb/IIIa blockers also have this effect and whether treatment costs can be reduced. Effects similar to those described for abciximab in patients undergoing PTA have been described for other GP IIb/IIIa blockers in several cardiologic studies.…”

mentioning

confidence: 99%

Use of Abciximab and Tirofiban in Patients with Peripheral Arterial Occlusive Disease and Arterial Thrombosis

Schweizer

Kirch²,

Koch

et al. 2003

Angiology

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Acute peripheral arterial occlusive disease is an important factor affecting the mobility and mortality rate of elderly patients. Catheter-guided arterial thrombolysis in these patients has its limitations: long lysis times, early occlusions, and high restenosis rates. The study investigated whether the use of tirofiban has the same favorable effect as the glycoprotein (GP) IIb/IIIa receptor antagonist abciximab and whether lysis times can be shortened and the disease course positively influenced by these substances. Sixty patients were randomly assigned to 2 groups. Each group received 5 mg recombinant tissue-type (rt-PA) plasminogen activator by slow intra-arterial injection for 10 minutes followed by 5 mg rt-PA per hour and 500 IU heparin per hour IV. After randomization 1 group received a bolus of 0.25 mg abciximab per kg body weight followed by 10 mg per minute IV for 12 hours (heparin was reduced to 250 IU/hr). The other group received a bolus of 0.4 microg tirofiban per kg body weight as well as postinterventional medication with 0.1 microg tirofiban per minute and kg body weight for 24 hours. During medication with GP IIb/IIIa inhibitor, the patients received a reduced heparin dosage for 24 hours. After 24 hours both groups received 200 mg aspirin orally and full heparinization controlled on the basis of the partial thromboplastin time. The following efficacy criteria were analyzed: rehospitalization events, reintervention events, and amputations within 6 months. Secondary endpoints were changes in the Fontaine stage, the crurobrachial index, the distance to claudication, and the duration of local arterial lysis. No significant differences were found between the abciximab and tirofiban groups in terms of the rehospitalization, reintervention, or amputation rates, nor were there any group differences in the total number of events. The secondary parameters, such as the crurobrachial index, distance to claudication, and Fontaine stage, also showed no significant differences between the 2 groups within 6 months. The duration of lysis was significantly shorter in the abciximab group. Major bleeding events did not occur in either group. With regard to the adverse effect rate, there were no significant differences between the 2 groups. Both abciximab and tirofiban can be used successfully in patients with peripheral arterial occlusive disease and arterial thrombosis.

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Short- and Long-Term Results of Abciximab Versus Aspirin in Conjunction with Thrombolysis for Patients with Peripheral Occlusive Arterial Disease and Arterial Thrombosis

Cited by 28 publications

References 19 publications

Noncardiac applications of glycoprotein IIb/IIIa inhibitors

Noncardiac applications of glycoprotein IIb/IIIa inhibitors

Point of Care Testing of Aspirin Resistance in Patients With Vascular Disease

Use of Abciximab and Tirofiban in Patients with Peripheral Arterial Occlusive Disease and Arterial Thrombosis

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