Safety and Efficiency of Low Dose Intra-arterial Tirofiban in Mechanical Thrombectomy During Acute Ischemic Stroke

• Published in: Current neurovascular research Vol. 15; no. 2; p. 145
• Main Authors: Yu, Tongya, Lin, Yingying, Jin, Aiping, Zhang, Pei, Zhou, Xiaoyu, Fang, Min, Liu, Xueyuan
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 01.01.2018
• Subjects: Aged; Aged, 80 and over; Angiography, Digital Subtraction; Brain - diagnostic imaging; Brain - drug effects; Brain Ischemia - complications; Brain Ischemia - diagnostic imaging; Cohort Studies; Dose-Response Relationship, Drug; Female; Fibrinolytic Agents - therapeutic use; Humans; Injections, Intra-Arterial; Male; Middle Aged; Severity of Illness Index; Stroke - diagnostic imaging; Stroke - etiology; Stroke - therapy; Tirofiban - therapeutic use; Tissue Plasminogen Activator - therapeutic use; Tomography Scanners, X-Ray Computed; Treatment Outcome; mechanical thrombectomy; Tirofiban; reperfusion of distal vessel; Acute ischemic stroke; prognosis; bleeding complications
• DOI: 10.2174/1567202615666180605104931

In this study, we aimed to evaluate the safety and efficiency of low dose intra- arterial tirofiban in mechanical thrombectomy of acute ischemic stroke patients to facilitate the reperfusion of distal vessel. We retrospectively analyzed 54 consecutive acute ischemic patients who underwent mechanical thrombectomy for large-vessel occlusion. Patients were divided into two groups based on whether intra-arterial tirofiban was used during mechanical thrombectomy to facilitate the reperfusion of distal vessel. Patients in Non-tirofiban group (n=28) have received mechanical thrombectomy, while Patients in Tirofiban group (n=26) have received mechanical thrombectomy with a low dose intra-arterial tirofiban. We comparatively analyzed two groups of the bleeding complications, recanalization rate, 24-hour National Institutes of Health Stroke Scale score, functional independence of 90 day and mortality rate. Of 54 patients undergoing mechanical thrombectomy, baseline characteristics did not differ between the Tirofiban group and Non-tirofiban cohort. Symptomatic intracranial hemorrhage rates were not different between Tirofiban group and Non-tirofiban group (11.5 % vs. 14.3%). Total 47 (87.0%) patients have realized successful recanalization, no apparent difference between two groups (85.7% vs. 88.5%, P>0.05). Mean 24-hour National Institutes of Health Stroke Scale score was 9.24±6.85, 9.11±8.13 in the Non-tirofiban group and 9.39±5.31 in the Tirofiban group respectively, P>0.05. Total 20 (35.7%) patients have achieved functional independence (34.6% vs. 39.3%, P>0.05) at 90 days. Patients treated with tirofiban presented lower mortality when compared with those who were not treated with tirofiban without significant difference (10.7% versus 3.8%, P>0.05). Intra-arterial tirofiban may be safe in mechanical thrombectomy of acute ischemic stroke to facilitate the reperfusion of distal vessel, but has no beneficial effect on prognosis.