School of Medicine Publications and Presentations
Document Type
Article
Publication Date
3-2021
Abstract
Background
Glycoprotein IIb/IIIa inhibitor use in acute ischemic stroke (AIS) during mechanical thrombectomy (MT) and acute stenting and angioplasty is a topic consistently debated due to concerns over safety and efficacy. Tirofiban is a glycoprotein IIb/IIIa used throughout the world now more commonly used during MT. We report the analysis of all AIS patients treated with Eptifibatide + MT vs. Tirofiban + MT.
Methods
Using a prospectively collected endovascular database at a CSC between 2013 and 2019, workflow, and outcomes were recorded. Patients are given Tirofiban, and patients given Eptifibatide were analyzed to obtain baseline demographics, modified Ranking Scale (mRS) at discharge, and 90 days follow up, pre and post thrombolysis in cerebral infarction (TICI), mortality rate, and hemorrhage rates.
Results
A total of 571 MT patients were treated: of those, 89 patients (average age 69.25 ± 14.21, 25.84% female) with underlying intracranial atherosclerosis were treated with a GpIIb/IIIa inhibitor. Analysis of 40.45% (36/89) patients treated with Tirofiban + MT and 59.55% (53/89) patients with Eptifibatide + MT was performed. There was no statistically significant difference in NIHSS upon admission (p = .441). Four patients (11.11%) in the Tirofiban + MT cohort had symptomatic hemorrhage versus four patients (7.55%) in the Eptifibatide + MT cohort (p = .564). There was no significant difference in mortality (p = .573) or final recanalization (p = .678) between the two cohorts.
Conclusion
Tirofiban use in MT does not increase the risk of symptomatic hemorrhages or mortality compared to Eptifibatide use in MT with acute stenting. Large prospective studies are warranted to confirm the safety/efficacy of Tirofiban in acute ischemic stroke patients treated with mechanical thrombectomy and acute stenting.
Recommended Citation
Movva, H., Rabah, R., Tekle, W., Georgiadis, A., Preston, L., Kotta, H., & Hassan, A. E. (2021). There is no difference in safety and efficacy with Tirofiban or Eptifibatide for patients undergoing treatment of large vessel occlusion and underlying intracranial atherosclerosis. Interdisciplinary Neurosurgery, 23, 100927. https://doi.org/10.1016/j.inat.2020.100927
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Publication Title
Interdisciplinary Neurosurgery
DOI
10.1016/j.inat.2020.100927
Academic Level
faculty
Mentor/PI Department
Neurology
Comments
Original published version available at https://doi.org/10.1016/j.inat.2020.100927