Shuai Zhang1, Yonggang Hao2, Xiguang Tian3, Wenjie Zi4, Huaiming Wang5, Dong Yang6, Meng Zhang7, Xinjiang Zhang8, Yongjie Bai9, Zibao Li10, Bo Sun11, Shun Li12, Xiaobing Fan4, Xinfeng Liu13, Gelin Xu14. 1. Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China; Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China; Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China. 2. Department of Neurology, SIR RUN RUN SHAW Hospital School of Medicine, Zhejiang University, Hangzhou, China; Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China. 3. Department of Neurology, The Chinese Armed Police Force Guangdong Armed Police Corps Hospital, Guangzhou, China. 4. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China. 5. Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China; Department of Neurology, The 89(th) Hospital of the People's Liberation Army, Weifang, China. 6. Department of Neurology, Jinling Hospital, Second Military Medical University, Nanjing, China. 7. Department of Neurology, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China. 8. Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China. 9. Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China; Department of Neurology, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, Luoyang, China. 10. Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China; Department of Neurology, Yijishan Hospital of Wannan Medical College, Wuhu, China. 11. Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China; Department of Neurology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China. 12. Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, China. 13. Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China. 14. Department of Neurology, Jinling Clinical College of Nanjing Medical University, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu, China. Electronic address: gelinxu@nju.edu.cn.
Abstract
PURPOSE: To assess the safety of low-dose intra-arterial (IA) tirofiban bolus after unsuccessful mechanical thrombectomy in patients with ischemic stroke due to large artery occlusion in anterior cerebral circulation. MATERIALS AND METHODS: Patients with ischemic stroke who were treated with mechanical thrombectomy were enrolled in a multicenter registry. Low-dose tirofiban was injected into the residual arterial thrombus in patients after unsuccessful mechanical thrombectomy. The major safety measurement was defined as symptomatic intracranial hemorrhage (SICH). The functional outcome at 90 days was assessed with the modified Rankin Scale, and a score of 0-2 was defined as favorable. RESULTS: Of the 632 enrolled patients, 154 (24.4%) received IA tirofiban treatment. The SICH rate was 13.6% (21/154) in patients with tirofiban and 16.7% (80/478) in patients without tirofiban (P = .361). IA tirofiban was not associated with increased risk of SICH (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.36-1.31; P = .26). IA tirofiban treatment did not increase the risk of mortality at 90 days of the index stroke (OR, 0.66; 95% CI, 0.36-1.31; P = .15). Patients with large artery atherosclerosis stroke who were treated with tirofiban were associated with decreased risk of death (OR, 11.3% vs 23.4%; P = .042) compared to patients who were not treated with tirofiban. CONCLUSIONS: Low-dose IA tirofiban administration may be relatively safe in patients with ischemic stroke after unsuccessful recanalization.
PURPOSE: To assess the safety of low-dose intra-arterial (IA) tirofiban bolus after unsuccessful mechanical thrombectomy in patients with ischemic stroke due to large artery occlusion in anterior cerebral circulation. MATERIALS AND METHODS:Patients with ischemic stroke who were treated with mechanical thrombectomy were enrolled in a multicenter registry. Low-dose tirofiban was injected into the residual arterial thrombus in patients after unsuccessful mechanical thrombectomy. The major safety measurement was defined as symptomatic intracranial hemorrhage (SICH). The functional outcome at 90 days was assessed with the modified Rankin Scale, and a score of 0-2 was defined as favorable. RESULTS: Of the 632 enrolled patients, 154 (24.4%) received IA tirofiban treatment. The SICH rate was 13.6% (21/154) in patients with tirofiban and 16.7% (80/478) in patients without tirofiban (P = .361). IA tirofiban was not associated with increased risk of SICH (odds ratio [OR], 0.69; 95% confidence interval [CI], 0.36-1.31; P = .26). IA tirofiban treatment did not increase the risk of mortality at 90 days of the index stroke (OR, 0.66; 95% CI, 0.36-1.31; P = .15). Patients with large artery atherosclerosis stroke who were treated with tirofiban were associated with decreased risk of death (OR, 11.3% vs 23.4%; P = .042) compared to patients who were not treated with tirofiban. CONCLUSIONS: Low-dose IA tirofiban administration may be relatively safe in patients with ischemic stroke after unsuccessful recanalization.
Authors: Marios Psychogios; Alex Brehm; Elena López-Cancio; Gian Marco De Marchis; Elena Meseguer; Aristeidis H Katsanos; Christine Kremer; Peter Sporns; Marialuisa Zedde; Adam Kobayashi; Jildaz Caroff; Daniel Bos; Sabrina Lémeret; Avtar Lal; Juan F Arenillas Journal: Eur Stroke J Date: 2022-06-03
Authors: Lili Zhao; Yating Jian; Tao Li; Heying Wang; Zhang Lei; Man Sun; Ye Li; Yiheng Zhang; Meijuan Dang; Wang Huqing; Sun Hong; Zhang Ru; Hongxing Zhang; Yi Jia; Luo Guogang; Zhang Guilian Journal: Biochem Res Int Date: 2020-04-27