Effect of tirofiban on perioperative thrombotic events in patients with unruptured intracranial aneurysms accepted stent-assisted coil embolization
10.3760/cma.j.cn115354-20200220-00091
- VernacularTitle:替罗非班对颅内未破裂动脉瘤支架辅助弹簧圈栓塞围手术期血栓事件发生的影响研究
- Author:
Huakun LIU
1
;
Peng WANG
;
Lei ZHANG
;
Chaolai LIU
;
Yafei ZHOU
;
Zhe LU
;
Hui LI
;
Zhongrui YAN
;
Jianfeng CHU
Author Information
1. 济宁市第一人民医院神经内科 272111
- Keywords:
Tirofiban;
Safety;
Thrombotic event;
Stent-assistance;
Coil;
Unruptured intracranial aneurysm
- From:
Chinese Journal of Neuromedicine
2020;19(8):794-798
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety of intraoperative prophylactic addition of tirofiban on the basis of preoperative oral administration of aspirin and clopidogrel in patients with unruptured intracranial aneurysms accepted stent-assisted coil embolization, and explore the effect of tirofiban on perioperative thrombotic events.Methods:The clinical data of 275 patients with unruptured intracranial aneurysms who underwent stent assisted coil embolization in our hospital from January 2016 to December 2019 were retrospectively collected. Among them, 110 patients admitted to our hospital from January 2016 to December 2017 only received preoperative oral administration of aspirin and clopidogrel combined with antiplatelet treatment (classic group), and 165 patients admitted to out hospital from January 2018 to December 2019 received intraoperative prophylactic addition of tirofiban on the basis of preoperative oral administration of aspirin and clopidogrel (improved group). The differences of perioperative safety and thrombotic events between the two groups were compared and analyzed.Results:The incidence of intraoperative visual thrombotic events in the classic group and the improved group were 6.4% (7/110) and 1.2% (2/165), respectively, with significant difference ( P<0.05); the incidence of postoperative thrombotic events was 4.5% (5/110) and 2.4% (4/165), respectively, without significant difference ( P>0.05); the incidence of urethrorrhagia was 9.1% (10/110) and 21.2% (35/165), respectively, with significant difference ( P<0.05); and the incidence of gingival hemorrhage was 13.6% (15/110) and 19.4% (32/165), respectively, without significant difference ( P>0.05). No acute gastrointestinal hemorrhage or cerebral hemorrhage occurred in both groups; urethrorrhagia and gingival hemorrhage were transient and relieved spontaneously. Conclusion:Intraoperative prophylactic addition of tirofiban on the basis of preoperative oral administration of aspirin and clopidogrel can reduce the incidence of intraoperative visual thrombotic events without increasing the risk of hemorrhage in stent-assisted coil embolization of unruptured intracranial aneurysms.
