Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Sun, Lili, Zhang, Jinping, Song, Yun, Zhao, Wei, Zheng, Meimei, Zhang, Jun, Yin, Hao, Wang, Wei, Meng, Yao, Han, Ju
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
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
_version_ 1784592144027090944
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
work_keys_str_mv AT sunlili safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT zhangjinping safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT songyun safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT zhaowei safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT zhengmeimei safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT zhangjun safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT yinhao safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT wangwei safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT mengyao safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis
AT hanju safetyandefficacyofprophylactictirofibaninfusionforacuteintracranialintraproceduralstentthrombosis