Effects of Antecedent Intravenous Thrombolysis on Endovascular Treatment of Acute Stroke Using Tirofiban.

Abstract

PURPOSE:

To investigate whether preceding intravenous thrombolysis combined with tirofiban in patients with acute ischemic stroke undergoing endovascular treatment is safe and effective.

MATERIALS AND METHODS:

Consecutive data were identified for patients who experienced acute ischemic stroke and were admitted to 2 comprehensive stroke centers from January 2015 to August 2021. All patients were divided into 2 groups-a thrombolytic with tirofiban group and a tirofiban-alone group-on the basis of whether intravenous thrombolysis before emergency endovascular angioplasty was used. Multivariate regression and propensity adjustment analyses were performed to characterize differences in safety and clinical outcomes between the 2 groups.

RESULTS:

Of 373 eligible patients, 111 (29.7%) were treated with thrombolysis with tirofiban. There was a significant difference in the rate of any intracerebral hemorrhage (35.1% vs 24.8%; P = .04) but not in the rates of symptomatic intracerebral hemorrhage (16.2% vs 11.5%; P = .23) and reocclusion at 24 hours (5.4% vs 7.6%; P = .51) between the 2 groups. Multivariate regression analysis revealed that intravenous thrombolysis was not associated with any or symptomatic intracerebral hemorrhage, artery occlusion, functional outcome, or death at the 3-month follow-up (all adjusted P > .05). After propensity adjustment, the thrombolytic with tirofiban group showed nonsignificant rates of clinical and safety outcomes compared with those of the tirofiban-alone group (all P > .05).

CONCLUSIONS:

Tirofiban may be used without increasing the risk of adverse events in selected patients who experienced ischemic stroke and were treated with intravenous thrombolysis and endovascular therapy.

• Authors: Xianjin Shang, Caifeng He, Ke Yang, Yapeng Guo, Zhiming Zhou, Wenjie Zi
• Journal: Journal of vascular and interventional radiology : JVIR (J Vasc Interv Radiol) Vol. 34 Issue 3 Pg. 420-426 (03 2023) ISSN: 1535-7732 [Electronic] United States
• PMID: 36509235 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 SIR. Published by Elsevier Inc. All rights reserved.

Chemical References

• Tirofiban
• Fibrinolytic Agents

Topics

• Humans
• Tirofiban
• Ischemic Stroke
• Brain Ischemia (therapy)
• Treatment Outcome
• Stroke (therapy)
• Fibrinolytic Agents
• Cerebral Hemorrhage (chemically induced, drug therapy)
• Thrombolytic Therapy