The role of antiplatelet therapy in aneurysm coiling

Neurol Res. 2014 Apr;36(4):383-8. doi: 10.1179/1743132814Y.0000000317. Epub 2014 Feb 20.


Neurointerventional surgery offers the potential to deliver remarkable intravascular therapies for various neurovascular diseases and stroke. This approach, however, carries a risk of complications that need to be kept to a minimum. Thromboembolism is one of the most consequential complications of neurointerventional surgery in the treatment of intracranial aneurysms. Both antiplatelet and anticoagulant therapies have shown to reduce the risk of thromboembolism in this setting. In this paper, we review the role of antiplatelet therapy in the endovascular management of intracranial aneurysms. For unruptured aneurysms, the use of antiplatelet agents to pre-medicate patients before and during the procedure appears safe and effective in reducing the thrombotic risk. Abciximab has not been extensively studied, but seems to be safe as a salvage maneuver in the case of thrombus formation even in ruptured aneurysms (when the dome is relatively secure) with low rates of intraprocedure and procedure hemorrhagic complications. Further innovation and research are needed to further reduce thromboembolic risks of aneurysm coiling.

Keywords: Abciximab,; Aneurysm,; Antiplatelet therapy,; Aspirin,; Clopidogrel,; Coiling,; Complication; Thromboembolism,.

Publication types

  • Review

MeSH terms

  • Abciximab
  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / drug therapy
  • Aneurysm, Ruptured / surgery
  • Antibodies, Monoclonal / therapeutic use
  • Drug Resistance
  • Endovascular Procedures* / adverse effects
  • Humans
  • Immunoglobulin Fab Fragments / therapeutic use
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / drug therapy*
  • Intracranial Aneurysm / surgery*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Thromboembolism / etiology


  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Platelet Aggregation Inhibitors
  • Abciximab