联合使用抗血栓药物包括阿昔单抗与神经介入手术相关的脑出血

Adnan I. Qureshi, M. Saad, Osama O. Zaidat, Jose I. Suarez, Michael J. Alexander, M. Fareed, K. Suri, Z. Ali, L. Hopkins
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引用次数: 118

摘要

背景-我们报道了在接受神经介入手术的患者中,与联合使用抗血栓药物(包括阿昔单抗)相关的致命性脑出血的发生。报告摘要- 7例患者(平均年龄60岁,范围46 - 73岁)发生与神经介入手术和静脉使用阿昔单抗相关的致命性脑出血。手术包括颈内动脉血管成形术和支架置入术(n=4),颅内颈内动脉血管成形术(n=1),大脑中动脉血管成形术(n=2)。5例患者术后1小时内出现临床恶化,其余2例患者术后7、8小时出现临床恶化。所有患者均接受肝素和氯吡格雷治疗;其中6人还服用了阿司匹林。结论:近期发生脑缺血事件的患者在神经介入治疗后可发生脑出血,特别是在积极抗栓治疗时。
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Intracerebral Hemorrhages Associated With Neurointerventional Procedures Using a Combination of Antithrombotic Agents Including Abciximab
Background— We report the occurrence of fatal intracerebral hemorrhage associated with using a combination of antithrombotic agents, including abciximab, in patients undergoing neurointerventional procedures. Summary of Report— Seven patients (average age 60, range 46 to 73 years) developed fatal intracerebral hemorrhages associated with neurointerventional procedures and the use of intravenous abciximab. The procedures included angioplasty and stent placement in the cervical internal carotid artery (n=4), angioplasty of the intracranial internal carotid artery (n=1), and angioplasty of the middle cerebral artery (n=2). Clinical deterioration was observed within 1 hour of the procedure in 5 patients and 7 and 8 hours after the procedure, respectively, in the remaining 2 patients. All patients had received heparin and clopidogrel; 6 had also received aspirin. Conclusions— Intracerebral hemorrhages can occur after neurointerventional procedures in patients with recent cerebral ischemic events, particularly when aggressive antithrombotic treatment is used.
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