Intraarterially Administered Abciximab as an Adjuvant Thrombolytic Therapy: Report of Three Cases

can be used as an adjuvant therapy to facilitate thrombo-lysis for acute cerebrovascular occlusion. However, to our knowledge, the intraaterial administration of abciximab has not been reported. We recently treated three patients with acute thrombosis of the cerebral arteries by using an intraarterial infusion of urokinase and abciximab. Even with small doses, we achieved rapid and complete recana-lization without complications. We believe that the intraar-terial infusion of abciximab may be promising for effective and safe recanalization of acute thrombotic occlusion of cerebral arteries. The most important objective in the treatment of acute cerebral arterial occlusion is a rapid and safe restoration of the blood flow. However, neurointer-ventionalists commonly encounter cerebrovascular occlusions resistant to thrombolytic agents. Recent studies indicate that the key factor in this resistance is an explosive thrombin generation, and adjuvant use of potent antiplatelet agents, such as abciximab, can facilitate thrombolysis by blocking this process (1–4). However, the systemic use of abciximab can be dan-gerous in cerebrovascular thrombotic lesions. The risk of cerebral hemorrhage after acute occlusion of cerebral arteries can be increased with the use of thrombolytic or antiplatelet agents. In addition, thromboembolic complications can develop during ce-rebrovascular interventions with high hemorrhagic risks, such as embolization of ruptured intracranial aneurysms or ruptured arteriovenous malformations. Therefore, the reduction of hemorrhagic risk, as well as the rapid and successful reopening of vessels, is important, espe-cially in the treatment of acute cerebrovascular throm-boembolic lesions. We recently treated three patients with acute throm-bosis of the cerebral artery. With an intraarterial infusion of urokinase and abciximab, we achieved rapid and complete recanalization without complica-tions. In this report, we present our cases and de-scribe the advantages of the intraarterial use of ab-ciximab in cerebrovascular interventions