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Administration of eptifibatide during endovascular treatment of ruptured cerebral aneurysms reduces the rate of thromboembolic events

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Thromboembolic complications are the most frequent complications of endovascular treatment of ruptured intracranial aneurysms. The optimal protocol to prevent thromboembolic complications during coil embolization does not yet exist. The aim of this study was to investigate the effectiveness and safety of eptifibatide for the prevention of thromboembolic complications during elective coil embolization of ruptured cerebral aneurysms.

Methods

A consecutive series of 100 patients (group 1) with ruptured intracranial aneurysm were treated using endovascular coil embolization. At the beginning of the procedure, all patients received an intra-arterial bolus (0.2 mg/kg) of eptifibatide. The following data were collected: degree of aneurysmal occlusion after treatment, thromboembolic and hemorrhagic complications and other intraoperative adverse events. The results were compared with those from a control group (group 2) which were analyzed retrospectively. Group 2 consisted of 100 previous patients with ruptured aneurysm managed with coil embolization who had received heparin and/or aspirin at the beginning of the procedure.

Results

(1) Patient populations in groups 1 and 2 were considered statistically comparable, except that group 1 (eptifibatide) included more wide-necked aneurysms (p = 0.011). (2) There were less thromboembolic complications in group 1 (p = 0.011): seven intraoperative complications in group 1 versus 20 in group 2. (3) Intraoperative hemorrhagic complications were statistically comparable in both groups (p = 1).

Conclusion

Eptifibatide was effective in lowering the intraoperative thromboembolic complication rate in ruptured aneurysms treated with coil embolization and did not increase the hemorrhagic risk.

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Ethics Committee of the Nice University Hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Unité de NeuroInterventionnelle, Hôpital St Roch, 5 rue Pierre Devoluy, Nice, 06000, France

    Jacques Sedat & Yves Chau

  2. Service de santé publique et d’information médicale hôpital La Timone, CHU Marseille, Marseille, France

    Jean Gaudard

  3. Unité de NeuroVasculaire, Hôpital St Roch, Nice, France

    Laurent Suissa & Sylvain Lachaud

  4. Unité de Neurochirurgie, Hôpital Pasteur, Nice, France

    Michel Lonjon

Authors
  1. Jacques Sedat
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  2. Yves Chau
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  4. Laurent Suissa
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  5. Sylvain Lachaud
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Correspondence to Jacques Sedat.

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Sedat, J., Chau, Y., Gaudard, J. et al. Administration of eptifibatide during endovascular treatment of ruptured cerebral aneurysms reduces the rate of thromboembolic events. Neuroradiology 57, 197–203 (2015). https://doi.org/10.1007/s00234-014-1452-x

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  • DOI: https://doi.org/10.1007/s00234-014-1452-x

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