Use of Abciximab During Infrainguinal Peripheral Vascular Interventions: Initial Experience

The use of abciximab in conjunction with infrainguinal angioplasty in 16 patients over an 18-month period in 1999 was investigated. Abciximab was given to patients thought to be at high risk for a thrombotic or embolic complication. Ten patients had high-grade stenoses or occlusions in the popliteal artery and superficial femoral artery; six patients had stenoses or occlusions below the popliteal artery. After arterial access was achieved, all patients received a bolus of heparin. A weight-based nomogram, consisting of an initial bolus followed by an overnight infusion, was used to administer the abciximab. A less than 30% residual stenosis after angioplasty was considered a technical success. Patients were monitored for complications following the procedure and platelet counts were monitored for 24 hours. Technical success occurred in 94% (15116) of the patients. No significant effect on platelet count was noted. Two minor complications occurred. The major complication was a groin hematoma in a patient who was also undergoing chronic antiplatelet therapy with aspirin and clopidogrel. Abciximab has promise as an adjunct during complex infrainguinal arterial interventions but further study is needed.