Title:Safety and Efficacy of Intra-arterial Tirofiban Injection During Mechanical Thrombectomy for Large Artery Occlusion
Volume: 16
Issue: 5
Author(s): Ho J. Yi , Jae H. Sung*Dong H. Lee
Affiliation:
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul,Korea
Keywords:
Ischemic stroke, tirofiban, tissue plasminogen activator, thrombectomy, thrombolysis, thrombosis.
Abstract:
Objective: The safety and effect of intra-arterial (IA) tirofiban, a glycoprotein IIb/IIIa
inhibitor, during the stent retriever mechanical thrombectomy (MT) was investigated.
Methods: From January 2015 to May 2019, a total of 327 patients underwent mechanical thrombectomy
of large artery occlusions (LAO). Patients were classified into two groups: MT with IA
tirofiban (MTT) group and MT only (MTO, without IA tirofiban) group. Clinical outcomes, radiological
results, and various complications, such as post thrombectomy hemorrhage, symptomatic
hemorrhage, other systemic bleeding, and hemorrhagic transformation of infarct were evaluated by
comparing the MTT group and MTO group. In addition, subgroup analysis was performed for patients
who underwent MT with prior intravenous (IV) tissue plasminogen activator (t-PA).
Results: The MTT group needed a lower mean number of stent passes and showed a re-occlusion
rate as compared with the MTO group (P=0.038 and 0.022, respectively). Between the two groups,
there were no statistically significant differences in post thrombectomy hemorrhage, symptomatic
hemorrhage, other systemic bleeding complications, or hemorrhagic transformation of infarct (P =
0.511, 0.397, 0.429, and 0.355, respectively). In the subgroup analysis, similar findings were observed.
Conclusion: The use of IA tirofiban during MT seems to be safe and potentially more effective
than only MT without IA tirofiban, even in patients who used IV t-PA before MT.
