Abciximab in carotid stenting for postsurgical carotid restenosis: Intermediate results

Purpose: To report intermediate results of a pilot study in which the glyco protein IIb/IIIa receptor antagonist abciximab was given to patients during percutaneous carotid stenting for recurrent internal carotid artery (ICA) stenosis. The objective was to prevent procedure-related cerebral embolic e vents and decrease the incidence of recurrent stenosis. Methods: Sixteen patients (9 women; mean age 66.5 years, range 39-78) with severe ICA recurrent stenosis (>80%) underwent balloon angioplasty and sten ting. Before the procedure, abciximab was administered intravenously as a b olus (0.25 mg/kg) followed by a 12-hour continuous infusion (10 mu g/min). Results: Fifteen patients received stents (14 Wallstent and 1 Strecker); 1 vessel was dilated with only 50% improvement in luminal diameter. Two stent ed arteries had residual stenosis (<30%) but satisfactory luminal diameter was achieved in the remaining 13 (81%) arteries. There were no neurological ischemic events during or following the procedure, nor were there any blee ding or peripheral vascular complications. Duplex surveillance studies up t o 12 months revealed no significant recurrent stenosis in the treated vesse ls. Conclusions: The administration of abciximab in conjunction with percutaneo us revascularization procedures for postsurgical carotid artery stenosis ma y reduce cerebral ischemic episodes. It may also attenuate restenosis in th e treated artery.