Original Research ARTICLE

Front. Neurol., 12 February 2013 | http://dx.doi.org/10.3389/fneur.2013.00004

How safe is eptifibatide during urgent carotid artery stenting?

Hesham Allam1, Nirav Vora1, Randall C. Edgell2, R. Charles Callison3, Yasir Al-Khalili4, Michelle Storkan1 and Amer Alshekhlee1,3*
  • 1Department of Neurology and Psychiatry, Souers Stroke Institute, St. Louis University, St. Louis, MO, USA
  • 2Department of Neurology, University of Texas, Houston, TX, USA
  • 3SSM Neuroscience Institutes, DePaul Health Center, St. Louis, MO, USA
  • 4St. George’s University School of Medicine, St. George’s University, Grenada, West Indies

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: eptifibatide, carotid stenting, interventional, intracerebral hemorrhage

Citation: Allam H, Vora N, Edgell RC, Callison RC, Al-Khalili Y, Storkan M and Alshekhlee A (2013) How safe is eptifibatide during urgent carotid artery stenting? Front. Neur. 4:4. doi: 10.3389/fneur.2013.00004

Received: 23 October 2012; Accepted: 18 January 2013;
Published online: 12 February 2013.

Edited by:

Osama O. Zaidat, Medical College of Wisconsin, USA

Reviewed by:

Viktor Szeder, University of California, Los Angeles, USA
Mohamed S. Teleb, Memorial Sloan-Kettering Cancer Center, USA

Copyright: © 2013 Allam, Vora, Edgell, Callison, Al-Khalili, Storkan and Alshekhlee. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in other forums, provided the original authors and source are credited and subject to any copyright notices concerning any third-party graphics etc.

*Correspondence: Amer Alshekhlee, SSM Neurosciences Institutes, DePaul Health Center, 12255 DePaul Drive, Suite 200, St. Louis, MO 63044, USA. e-mail: aalshekh@slu.edu