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.

Comments

Original published version available at https://doi.org/10.1016/j.inat.2020.100927

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Publication Title

Interdisciplinary Neurosurgery

DOI

10.1016/j.inat.2020.100927

Academic Level

faculty

Mentor/PI Department

Neurology

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