Efficacy and safety of intravenous tirofiban after endovascular therapy in patients with intracranial atherosclerotic stroke / 国际脑血管病杂志

ABSTRACT

Objective:To investigate the efficacy and safety of intravenous tirofiban after endovascular therapy in patients with acute intracranial large atherosclerotic stroke.Methods:Patients with acute intracranial large atherosclerotic stroke received endovascular therapy in the Stroke Center, Nanjing Drum Tower Hospital from January 2018 to December 2020 were enrolled. The incidence of symptomatic intracranial hemorrhage in patients of tirofiban group and non-tirofiban group during perioperative period and the outcome after procedure at 90 d were analyzed.Results:A total of 172 patients were included. Their average age was 66.0 years and 126 patients were male (73.3%). Ninety-two patients (53.5%) used tirofiban, and 120 (69.8%) had good outcomes. Compared with the non-tirofiban group, the tirofiban group had a significantly higher rate of good outcome at 90 d after procedure (77.2% vs. 61.3%; P=0.023). The reocclusion rate was significantly lower (7.6% vs. 18.8%; P=0.039), while there was no statistically significant difference in the incidence of symptomatic intracranial hemorrhage during periprocedureal period (4.3% vs. 3.8%; P=0.990). There was a significant independent correlation between the use of tirofiban intravenously and the good outcome at 90 d after procedure, both in the overall patients (odds ratio 0.208, 95% confidence interval 0.064-0.680; P=0.009) and the patients with severe stroke (odds ratio 0.181, 95% confidence interval 0.050-0.658; P=0.009) were all the same. Conclusion:For patients with acute intracranial large atherosclerotic stroke who received intravascular therapy, intravenous tirofiban can significantly improve the clinical outcome at 90 d after procedure, and will not increase the risk of symptomatic intracranial hemorrhage.