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Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis
Periprocedural antithrombotic management with glycoprotein IIb/IIIa inhibitors (GPI) for intracranial artery stenting is still controversial. We sought to assess the safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis in routine clinical pra...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556246/ https://www.ncbi.nlm.nih.gov/pubmed/34716365 http://dx.doi.org/10.1038/s41598-021-00872-9 |
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author | Sun, Lili Zhang, Jinping Song, Yun Zhao, Wei Zheng, Meimei Zhang, Jun Yin, Hao Wang, Wei Meng, Yao Han, Ju |
author_facet | Sun, Lili Zhang, Jinping Song, Yun Zhao, Wei Zheng, Meimei Zhang, Jun Yin, Hao Wang, Wei Meng, Yao Han, Ju |
author_sort | Sun, Lili |
collection | PubMed |
description | Periprocedural antithrombotic management with glycoprotein IIb/IIIa inhibitors (GPI) for intracranial artery stenting is still controversial. We sought to assess the safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis in routine clinical practice. From January 2013 to December 2019, consecutive patients treated with endovascular stenting for symptomatic intracranial atherosclerotic stenosis (ICAS) were identified and dichotomized by whether tirofiban was used. The efficacy and safety outcomes were compared by propensity score matching. A total of 160 consecutive patients in the tirofiban group and 177 patients in the non-tirofiban group were enrolled. Propensity score matching analysis selected 236 matched patients. One acute intraprocedural stent thrombosis (AIST) occurred in patients receiving prophylactic tirofiban, while 8 in the non-tirofiban group. The incidence of AIST in the tirofiban group was significantly lower than that in the non-tirofiban group (0.8% vs 6.8%, P = 0.039). The periprocedural ischemic events (8.5% vs 5.1%, P = 0.424), periprocedural intracranial hemorrhage (4.2% vs 0.8%, P = 0.219) and 30-day total mortality (3.4% vs 0%, P = 0.125) were not statistically different between the two groups. Compared with conventional stenting angioplasty without tirofiban, tirofiban prophylactic infusion can lower the incidence of AIST, without increasing the risk of periprocedural intracranial hemorrhage and 30-day total mortality. However, there is no superiority in reducing periprocedural ischemic events. The current study adds more important insights to the available clinical evidence on the use of tirofiban during stenting of ICAS. |
format | Online Article Text |
id | pubmed-8556246 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-85562462021-11-01 Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis Sun, Lili Zhang, Jinping Song, Yun Zhao, Wei Zheng, Meimei Zhang, Jun Yin, Hao Wang, Wei Meng, Yao Han, Ju Sci Rep Article Periprocedural antithrombotic management with glycoprotein IIb/IIIa inhibitors (GPI) for intracranial artery stenting is still controversial. We sought to assess the safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis in routine clinical practice. From January 2013 to December 2019, consecutive patients treated with endovascular stenting for symptomatic intracranial atherosclerotic stenosis (ICAS) were identified and dichotomized by whether tirofiban was used. The efficacy and safety outcomes were compared by propensity score matching. A total of 160 consecutive patients in the tirofiban group and 177 patients in the non-tirofiban group were enrolled. Propensity score matching analysis selected 236 matched patients. One acute intraprocedural stent thrombosis (AIST) occurred in patients receiving prophylactic tirofiban, while 8 in the non-tirofiban group. The incidence of AIST in the tirofiban group was significantly lower than that in the non-tirofiban group (0.8% vs 6.8%, P = 0.039). The periprocedural ischemic events (8.5% vs 5.1%, P = 0.424), periprocedural intracranial hemorrhage (4.2% vs 0.8%, P = 0.219) and 30-day total mortality (3.4% vs 0%, P = 0.125) were not statistically different between the two groups. Compared with conventional stenting angioplasty without tirofiban, tirofiban prophylactic infusion can lower the incidence of AIST, without increasing the risk of periprocedural intracranial hemorrhage and 30-day total mortality. However, there is no superiority in reducing periprocedural ischemic events. The current study adds more important insights to the available clinical evidence on the use of tirofiban during stenting of ICAS. Nature Publishing Group UK 2021-10-29 /pmc/articles/PMC8556246/ /pubmed/34716365 http://dx.doi.org/10.1038/s41598-021-00872-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Sun, Lili Zhang, Jinping Song, Yun Zhao, Wei Zheng, Meimei Zhang, Jun Yin, Hao Wang, Wei Meng, Yao Han, Ju Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
title | Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
title_full | Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
title_fullStr | Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
title_full_unstemmed | Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
title_short | Safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
title_sort | safety and efficacy of prophylactic tirofiban infusion for acute intracranial intraprocedural stent thrombosis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8556246/ https://www.ncbi.nlm.nih.gov/pubmed/34716365 http://dx.doi.org/10.1038/s41598-021-00872-9 |
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