TY - JOUR
T1 - Reduced thrombus burden with abciximab delivered locally before percutaneous intervention in saphenous vein grafts
AU - Barsness, Gregory W.
AU - Buller, Christopher
AU - Ohman, E. Magnus
AU - Schechter, Elliot
AU - Pucillo, Anthony
AU - Taylor, Marc A.
AU - Miller, Michael J.
AU - Reiner, Jonathan S.
AU - Churchill, David
AU - Chandler, A. Bleakley
AU - Gonzalez, Mark
AU - Smith, James
AU - Tommaso, Carl
AU - Berdan, Lisa G.
AU - Wildermann, Nancy M.
AU - Hasdai, David
AU - Holmes, David R.
PY - 2000
Y1 - 2000
N2 - Background: Existing thrombus can complicate percutaneous saphenous vein graft (SVG) intervention. Local delivery of thrombolytics has been used to reduce the thrombus burden often associated with these interventions. We sought to determine whether local delivery of a platelet glycoprotein IIb/IIIa inhibitor is feasible and can reduce thrombus burden before percutaneous SVG intervention. Methods: We performed a multicenter pilot study of abciximab (0.25 mg/kg) given by local delivery catheter before percutaneous intervention for de novo SVG stenoses followed by intravenous infusion. All patients (n = 58) had ≥60% stenosis and Thrombolysis In Myocardial Infarction (TIMI) grade >0 flow in an SVG of 3 to 4 mm in diameter. Percent diameter stenosis, TIMI thrombus grade, and TIMI flow grade were measured before and after delivery of abciximab and after intervention. Results: Median percent diameter stenosis improved from 69% to 45% (P = .0001) after local delivery, and TIMI thrombus grade ≥ 1 incidence reduced from 68% to 34% (P = .0001). TIMI flow grade was not significantly affected (P = .12). All patients had a successful intervention (≤50% residual stenosis). Conclusions: Local abciximab delivery before percutaneous SVG intervention is associated with significantly reduced thrombus burden, significantly improved percent diameter stenosis, and excellent acute procedural results. Further studies of this approach are warranted to define its clinical utility.
AB - Background: Existing thrombus can complicate percutaneous saphenous vein graft (SVG) intervention. Local delivery of thrombolytics has been used to reduce the thrombus burden often associated with these interventions. We sought to determine whether local delivery of a platelet glycoprotein IIb/IIIa inhibitor is feasible and can reduce thrombus burden before percutaneous SVG intervention. Methods: We performed a multicenter pilot study of abciximab (0.25 mg/kg) given by local delivery catheter before percutaneous intervention for de novo SVG stenoses followed by intravenous infusion. All patients (n = 58) had ≥60% stenosis and Thrombolysis In Myocardial Infarction (TIMI) grade >0 flow in an SVG of 3 to 4 mm in diameter. Percent diameter stenosis, TIMI thrombus grade, and TIMI flow grade were measured before and after delivery of abciximab and after intervention. Results: Median percent diameter stenosis improved from 69% to 45% (P = .0001) after local delivery, and TIMI thrombus grade ≥ 1 incidence reduced from 68% to 34% (P = .0001). TIMI flow grade was not significantly affected (P = .12). All patients had a successful intervention (≤50% residual stenosis). Conclusions: Local abciximab delivery before percutaneous SVG intervention is associated with significantly reduced thrombus burden, significantly improved percent diameter stenosis, and excellent acute procedural results. Further studies of this approach are warranted to define its clinical utility.
UR - http://www.scopus.com/inward/record.url?scp=0034066147&partnerID=8YFLogxK
U2 - 10.1016/S0002-8703(00)90014-0
DO - 10.1016/S0002-8703(00)90014-0
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C2 - 10783216
AN - SCOPUS:0034066147
VL - 139
SP - 824
EP - 829
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 5
M1 - S0002-8703(00)90014-0
ER -