Case summary of intra-procedural anti-coagulation therapy
| Case No. Imaging Findings | Activated Clotting Time before Treatment (s) | Initial Therapy | Activated Clotting Time after Treatment (s) | Findings after Anticoagulation Therapy | Additional Therapy* | Technical Result |
|---|---|---|---|---|---|---|
| 1 Thrombus at coil-parent artery interface | 299 | Abciximab bolus and infusion | Not measured | Small residual thrombus | Abciximab infusion for 12 hr | No follow-up angiography at 24 hr |
| 2 Thrombus at coil-parent artery interface | 238 | Heparin bolus, 3000 U | 318 | Unchanged after 30 min | Abciximab bolus and infusion | Resolution of thrombus at 30 min after abciximab |
| 3 Coil loop, thrombus narrowing right P1 50% | 288 | Heparin infusion, 1000 U/hr | 400 | Resolved thrombus, coil protruding into left P1 | Abciximab bolus and infusion | Resolved thrombus |
| 4 Thrombus at coil-parent artery interface, extending into distal basilar and right P1 | 250 | Heparin bolus, 2000 U | Not measured | Basilar thrombus resolved after 20 min, nonocclusive thrombus right P2 | Heparin infusion for 24 hr | No follow-up angiography at 24 hr |
| 5 Thrombus at coil-parent artery interface, extending into left and right P1 | 200 | Heparin bolus, 2000 U | 300 | Small residual, nonocclusive thrombus right P1 | Heparin infusion for 24 hr | Resolution of thrombus at 24 hr |
| 6 Thrombus at coil-parent artery interface | 155 | Heparin bolus, 3000 U | 300 | Small residual thrombus | Heparin infusion for 24 hr | No follow-up angiography at 24 hr |
| 7 Thrombus at coil-parent artery interface | 220 | Heparin bolus, 4000 U | Not measured | Resolved thrombus | Heparin infusion for 24 hr | Resolved thrombus |
| 8 Thrombus at coil-parent artery interface | Not recorded | Heparin bolus, 5000 U | 270 | Unchanged after 30 min | Integrilin bolus and infusion | Resolution of thrombus at 10 min after Integrilin |
| 9 Thrombus at coil-parent artery interface | 307 | Abciximab bolus and infusion | Not measured | Small residual thrombus | Abciximab infusion for 12 hr | No follow-up angiography at 24 hr |
Note.—P1 indicates P1 segment; P2, P2 segment.
* Integrilin dose: bolus, 180 μg/kg; infuse, 2 μg/kg/min for 20 hr. Abciximab dose: bolus, 0.25 mg/kg; infuse, 10 μg/min for 12 hr. Heparin infusion: heparin dosed to maintain a partial thromboplastin time of 50 to 70 s.