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Front Neurol. 2013 Feb 12;4:4. doi: 10.3389/fneur.2013.00004. eCollection 2013.

How Safe is Eptifibatide during Urgent Carotid Artery Stenting?

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1
Department of Neurology and Psychiatry, Souers Stroke Institute, St. Louis University St. Louis, MO, USA.

Abstract

BACKGROUND:

Glycoprotein IIB/IIIA inhibitors are occasionally utilized during carotid artery stenting (CAS) in the presence or absence of a visualized intra-operative thrombus.

OBJECTIVE:

We assess the hemorrhagic and clinical outcomes associated with the use of eptifibatide during CAS.

METHODS:

A retrospective analysis of prospectively collected data on patients with the diagnosis of carotid artery stenosis underwent CAS in a single center. We identified those who received intravenous eptifibatide intra-operatively and compared to the rest of the cohort. Hemorrhagic outcomes included intracerebral hemorrhage (ICH) or groin hematoma that occurred during the hospital stay.

RESULTS:

In this analysis, 81 patients had CAS during a 3-year span; 16 of those had received 15 mg of intravenous eptifibatide intra-operatively. The mean age of the treated and untreated patients was similar (65.6 ± 13.4 versus 65.4 ± 10.2; P = 0.13). One patient (1.2%) in this series had ICH in the perioperative period that occurred in the non-eptifibatide group. Five patients (6.2%) in this series had groin hematoma; only one in the non-eptifibatide group required surgical repair. No mortality was reported and clinical outcomes including discharge modified Rankin scale, NIH stroke scale, as well as discharge destination were similar in both groups. A stratified analysis among those who underwent an urgent CAS showed no significant differences in the risks of hemorrhages or any clinical outcome (P > 0.05).

CONCLUSION:

The use of eptifibatide during CAS is safe. The risk of any hemorrhagic complication is rare in this series; however, a prospective study to validate this observation will be helpful.

KEYWORDS:

carotid stenting; eptifibatide; interventional; intracerebral hemorrhage

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