Rescue Treatment with Intra-arterial Tirofiban Infusion and Emergent Carotid Stenting.
10.3349/ymj.2008.49.5.857
- Author:
Tae Jin SONG
1
;
Kee Oog LEE
;
Dong Joon KIM
;
Kyung Yul LEE
Author Information
1. Department of Neurology, Yonsei University College of Medicine, Seoul, Korea. kylee@yuhs.ac
- Publication Type:Case Report
- Keywords:
Carotid stent;
glycoprotein IIb/IIIa receptor blocker;
tissue plasminogen activator
- MeSH:
*Carotid Artery, Internal;
Carotid Stenosis/*drug therapy/radiography/surgery;
Emergency Treatment;
Humans;
Infusions, Intra-Arterial;
Male;
Middle Aged;
Stents;
Tyrosine/administration & dosage/*analogs & derivatives/therapeutic use
- From:Yonsei Medical Journal
2008;49(5):857-859
- CountryRepublic of Korea
- Language:English
-
Abstract:
Rapid arterial rethrombosis is associated with high-grade residual stenosis and usually occurs at the site of the initial occlusion, resulting in reocclusion of the recanalized artery. Platelets may play an active role in such rethrombosis after thrombolytic-induced clot lysis. Given that glycoprotein IIb/IIIa receptor blockers, like tirofiban, prevent thrombus formation by inhibiting the final common pathway of platelet aggregation, they may be helpful for treating rethrombosis after thrombolysis. A 64-year-old man presented with an acute ischemic stroke due to internal carotid artery (ICA) occlusion. The ICA was recanalized by intravenous thrombolysis but reoccluded shortly after recanalization. The reoccluded ICA was successfully recanalized using intra-arterial tirofiban. A carotid stent was subsequently inserted to relieve severe stenosis and to prevent recurrent stroke. Here, we report a case of rescue treatment of a successfully recanalized ICA by intra- arterial tirofiban. We suggest that rescue use of intra-arterial tirofiban may be effective and safe, especially in hemorrhage prone situations, due to the relatively lower dose of tirofiban compared with intravenous doses.
