Abciximab does not prevent ischemic lesions related to cerebral angiography: a randomized placebo-controlled trial.

BACKGROUND: To assess the efficiency of IIb/IIIa platelet receptor inhibition by abciximab in the prevention of silent embolism during digital subtraction angiography. METHODS: In this randomized, double-blind, prospective study, pre- and postangiographic diffusion-weighted magnetic resonance imaging (DWI) of 184 participants was evaluated for the occurrence of silent embolism. RESULTS: No significant relationship was found between the patients receiving abciximab before digital subtraction angiography (15 of 90; 16.7%) and patients in the placebo group (16 of 94; 17.0%) regarding postangiographic appearance of silent emboli (p = 0.9). CONCLUSIONS: IIb/IIIa receptor inhibition by abciximab does not diminish the occurrence of silent embolism during digital subtraction angiography. Our findings indicate that solid blood clots are not the origin of hyperintense lesions observed on DWI and enhance the role of alternative mechanisms.