Title:Safety and Efficiency of Low Dose Intra-arterial Tirofiban in Mechanical Thrombectomy During Acute Ischemic Stroke
VOLUME: 15 ISSUE: 2
Author(s):Tongya Yu, Yingying Lin, Aiping Jin, Pei Zhang, Xiaoyu Zhou, Min Fang* and Xueyuan Liu*
Affiliation:Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072, Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072, Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072, Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072, Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072, Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072, Department of Internal Neurology, Shanghai Tenth People`s Hospital of Tongji University, Middle Yanchang Rd. 301#, Zhabei District, Shanghai 200072
Keywords:Acute ischemic stroke, mechanical thrombectomy, Tirofiban, reperfusion of distal vessel, bleeding complications,
prognosis.
Abstract:Objective: 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.
Methods: 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.
Results: 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).
Conclusion: 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.
