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The Safety of Intra-arterial Tirofiban during Endovascular Therapy after Intravenous Thrombolysis
- Source :
- AJNR Am J Neuroradiol
- Publication Year :
- 2021
- Publisher :
- American Society of Neuroradiology (ASNR), 2021.
-
Abstract
- BACKGROUND AND PURPOSE: The safety and efficacy of tirofiban during endovascular therapy in patients undergoing intravenous thrombolysis with recombinant IV tPA remain unclear. This study aimed to investigate the safety and efficacy of intra-arterial tirofiban use during endovascular therapy in patients treated with IV tPA. MATERIALS AND METHODS: Using a multicenter registry, we enrolled patients with acute ischemic stroke who underwent endovascular therapy. Safety outcomes included postprocedural parenchymal hematoma type 2 and/or thick subarachnoid hemorrhage, intraventricular hemorrhage, and 3-month mortality. Efficacy outcomes included the successful reperfusion rate, postprocedural reocclusion, and good outcomes at 3 months (mRS scores of 0–2). The tirofiban effect on the outcomes was evaluated using a multivariable analysis while adjusting for potential confounders. RESULTS: Among enrolled patients, we identified 314 patients with stroke (279 and 35 patients in the no tirofiban and tirofiban groups, respectively) due to an intracranial artery occlusion who underwent endovascular therapy with intravenous thrombolysis. A multivariable analysis revealed no association of intra-arterial tirofiban with postprocedural parenchymal hematoma type and/or thick subarachnoid hemorrhage (adjusted OR, 1.07; 95% CI, 0.20–4.10; P = .918), intraventricular hemorrhage (adjusted OR, 0.43; 95% CI, 0.02–2.85; P = .467), and 3-month mortality (adjusted OR, 0.38; 95% CI, 0.04–1.87; P = .299). Intra-arterial tirofiban was not associated with good outcome (adjusted OR, 2.22; 95% CI, 0.89 –6.12; P = .099). CONCLUSIONS: Using intra-arterial tirofiban during endovascular therapy after IV tPA could be safe.
- Subjects :
- Subarachnoid hemorrhage
medicine.medical_treatment
Brain Ischemia
Hematoma
Fibrinolytic Agents
Occlusion
medicine
Humans
Thrombolytic Therapy
Radiology, Nuclear Medicine and imaging
cardiovascular diseases
Stroke
Interventional
business.industry
Endovascular Procedures
Intracranial Artery
Thrombolysis
Tirofiban
medicine.disease
Treatment Outcome
Intraventricular hemorrhage
Anesthesia
Neurology (clinical)
business
medicine.drug
Subjects
Details
- ISSN :
- 1936959X and 01956108
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- American Journal of Neuroradiology
- Accession number :
- edsair.doi.dedup.....041b506976edb8f94c92419c66ff60a1
- Full Text :
- https://doi.org/10.3174/ajnr.a7203