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Open Access 01-12-2020 | Tirofiban | Research article

Local tirofiban infusion for remnant stenosis in large vessel occlusion: tirofiban ASSIST study

Authors: Yong-Won Kim, Sung-Il Sohn, Joonsang Yoo, Jeong-Ho Hong, Chang-Hyun Kim, Dong-Hun Kang, Yong-Sun Kim, Seong-Joon Lee, Ji Man Hong, Jin Wook Choi, Yang-Ha Hwang, Jin Soo Lee

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

Compared with embolic occlusions, intracranial atherosclerotic stenosis (ICAS)-related large vessel occlusions (LVOs) often require rescue treatment following mechanical thrombectomy (MT). Herein, we hypothesized that local tirofiban infusion can be effective and safe for remnant stenosis in LVO during endovascular treatment and can improve clinical outcomes.

Methods

This observational multicenter registry study (January 2011 to February 2016) included patients with ICAS who underwent endovascular treatment for LVO within 24 h after stroke onset. An underlying fixed focal stenosis at the occlusion site observed on cerebral angiography during and after MT was retrospectively determined as a surrogate marker of ICAS. Procedural and clinical outcomes were compared between the tirofiban and non-tirofiban groups.

Results

Of 118 patients, 59 received local tirofiban infusion. Compared to the non-tirofiban group, patients were older (non-tirofiban group versus tirofiban group; median, 63 years vs. 71 years, p = 0.015) and the onset-to-puncture time was longer (median, 275 min vs. 395 min, p = 0.036) in the tirofiban group. The median percent of residual stenosis prior to rescue treatment tended to be higher in the tirofiban group (80 [71–86] vs. 83 [79–90], p = 0.056). Final reperfusion success (modified Treatment In Cerebral Ischemic 2b–3) was more frequent (42.4%vs. 86.4%, p = 0.016) and post-procedure parenchymal hematoma type 2 and/or thick subarachnoid hemorrhages were less frequent (15.3%vs. 5.1%, p = 0.068) in the tirofiban group. The frequency of favorable outcomes 3 months after endovascular treatment (modified Rankin Scale 0–2) was significantly higher in the tirofiban group (32.2% vs. 52.5%, p = 0.025), and tirofiban administration was an independent predictor of favorable outcomes (odds ratio, 2.991; 95% confidence interval, 1.011–8.848; p = 0.048).

Conclusions

Local tirofiban infusion can be a feasible adjuvant treatment option for patients with ICAS-LVO.

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Title: Local tirofiban infusion for remnant stenosis in large vessel occlusion: tirofiban ASSIST study
Authors: Yong-Won Kim
Sung-Il Sohn
Joonsang Yoo
Jeong-Ho Hong
Chang-Hyun Kim
Dong-Hun Kang
Yong-Sun Kim
Seong-Joon Lee
Ji Man Hong
Jin Wook Choi
Yang-Ha Hwang
Jin Soo Lee
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Tirofiban
Subarachnoid Hemorrhage
Stroke
Subarachnoid Hemorrhage
Thrombectomy
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-01864-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Local tirofiban infusion for remnant stenosis in large vessel occlusion: tirofiban ASSIST study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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