Abstract Details

Title Abciximab for Fluctuating Lacunar Syndrome

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 245

Objective

Background BACKGROUND: Lacunar strokes are often preceded by "warning syndromes" and are a major cause of progressive neurologic deficit. Controversy exists about the optimum management of Fluctuating Lacunar Syndromes (FLS). We present our experience using IV abciximab for FLS.

Design/Methods DESIGN/METHODS: We retrospectively identified all patients who received IV abciximab for FLS since 2005. Patient demographics, as well as the NIHSS score at four different times: at presentation, before IV abciximab, after IV abciximab, and at discharge; we also reviewed imaging reports for evidence of hemorrhagic conversion. The time of symptom onset and time of IV abciximab administration was also collected.

Results RESULTS: 51 patients who received IV abciximab for FLS had all four NIHSS scores recorded. The mean admission score was 5.5, and mean deterioration was 0.86 points. After IV abciximab, 60% of patients had an improved NIHSS score, 18% had a stable score and 22% had continued deterioration. The NIHSS decreased a mean of 4.5 in those with improvement. The mean increase in those that continued to worsen was 3.4 points. The overall mean score improvement at discharge was 1.9 points. No hemorrhagic conversions were identified after IV abciximab. Symptom onset time and IV abciximab administration time were known in 39 cases. In 33 of these IV abciximab was given within 24 hours of symptom onset. In the 6 patients that received IV abciximab beyond 24 hours, only 2 had improvement in NIHSS score.

Conclusions CONCLUSIONS: No optimal therapeutic options currently exist for lacunar stroke patients who deteriorate and are not candidates for IV rt-PA. Our results suggest that abciximab may be beneficial and safe for this population. Larger randomized trials will need to be conducted to prove its safety and efficacy.

Authors/Disclosures
Sarah Parker, MD (University of Tennessee Medical Center) PRESENTER	No disclosure on file
	No disclosure on file
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Clario.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Deepak S. Nair, MD (OSF HealthCare)	Dr. Nair has nothing to disclose.
Arun V. Talkad, MD, BA (OSF Healthcare)	Dr. Talkad has nothing to disclose.
David Z. Wang, DO, FAHA, FAAN (BNI, Neurology, Stroke)	Dr. Wang has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Mediwelcome.

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