Clinical Neuroradiology

, Volume 19, Issue 1, pp 73–81 | Cite as

Prevention and Treatment of Thromboembolism during Endovascular Aneurysm Therapy*

Review Article

Abstract

Thromboembolic events with partially or completely persisting neurologic deficits are reported in a substantial number of patients after endovascular aneurysm therapy. The authors discuss the current status of periinterventional coagulation management in endovascular aneurysm therapy. First, some basic aspects of coagulation physiology relevant to neurointerventions are introduced. Second, the most important pharmacological aspects of heparin, protamine sulfate, low-molecular-weight heparin, tissue plasminogen activator, acetylsalicylic acid, clopidogrel, abciximab, tirofiban and eptifibatide for neurointerventions are considered. Third, the use of these drugs in periinterventional coagulation management are discussed with special emphasis on current standards in anticoagulation/antiplatelet strategy and their impact on aneurysm perforation rates. Moreover, treatment of thrombotic complications of endovascular therapy of cerebral aneurysms is discussed.

Key Words:

Aneurysm Infarct Abciximab Complications Embolism Thrombosis 

Prophylaxe und Therapie von thromboembolischen Komplikationen bei der endovaskulären Aneurysmabehandlung

Zusammenfassung

Thromboembolische Ereignisse mit teilweise oder vollständig persistierenden neurologischen Defiziten werden in einer beträchtlichen Zahl von Patienten nach endovaskuläre Aneurysmabehandlung beobachtet. Die Autoren berichten über den Stand des periinterventionellen Gerinnungsmanagements bei der endovaskulären Aneurysmatherapie. Zunächst werden grundsätzliche Aspekte der Gerinnungsphysiologie diskutiert, soweit sie für neurointerventionelle Prozeduren relevant sind. Als Nächstes werden die wichtigsten pharmakologischen Aspekte von Heparin, Protamin, niedermolekularem Heparin, Gewebe-Plasminogenaktivator, Acetylsalicylsäure, Clopidogrel, Abciximab, Tirofiban und Eptifibatid diskutiert. Darüber hinaus wird die Verwendung dieser Medikamente im interventionellen Gerinnungsmanagement besprochen.

Schlüsselwörter:

Aneurysma Infarkt Abciximab Komplikationen Embolie Thrombose 

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Copyright information

© Urban & Vogel, Muenchen 2009

Authors and Affiliations

  1. 1.Department of NeuroradiologyUniversity Hospital EppendorfHamburgGermany
  2. 2.Department of NeuroradiologyUniversity Hospital EppendorfHamburgGermany

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