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(Stroke. 2002;33:1916.)
© 2002 American Heart Association, Inc.

Short Communication

Intracerebral Hemorrhages Associated With Neurointerventional Procedures Using a Combination of Antithrombotic Agents Including Abciximab

Adnan I. Qureshi, MD; Mustafa Saad, MD; Osama O. Zaidat, MD; Jose I. Suarez, MD; Michael J. Alexander, MD; M. Fareed; K. Suri, MD; Zulfiqar Ali, MD L. Nelson Hopkins, MD

From the Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York (A.I.Q., M.S., M.F.K.S., Z.A., L.N.H.), Buffalo, NY; Department of Neurology, University Hospitals of Cleveland (O.O.Z., J.I.S.), Cleveland, Ohio; and Division of Neurosurgery, Duke University (M.J.A.), Durham, NC.

Reprint requests to Adnan I. Qureshi, MD, Department of Neurosurgery, 3 Gates Circle, Buffalo, NY 14209-1194. E-mail aiqureshi{at}hotmail.com

Abstract

Background— We report the occurrence of fatal intracerebral hemorrhage associated with using a combination of antithrombotic agents, including abciximab, in patients undergoing neurointerventional procedures.

Summary of Report— Seven patients (average age 60, range 46 to 73 years) developed fatal intracerebral hemorrhages associated with neurointerventional procedures and the use of intravenous abciximab. The procedures included angioplasty and stent placement in the cervical internal carotid artery (n=4), angioplasty of the intracranial internal carotid artery (n=1), and angioplasty of the middle cerebral artery (n=2). Clinical deterioration was observed within 1 hour of the procedure in 5 patients and 7 and 8 hours after the procedure, respectively, in the remaining 2 patients. All patients had received heparin and clopidogrel; 6 had also received aspirin.

Conclusions— Intracerebral hemorrhages can occur after neurointerventional procedures in patients with recent cerebral ischemic events, particularly when aggressive antithrombotic treatment is used.

Key Words: abciximab • angioplasty • carotid stenosis • intracerebral hemorrhage • stents

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