Efficacy and safety of tirofiban in elderly patients with acute anterior circulation ICAS-LVO undergoing mechanical thrombectomy
10.3969/j.issn.1009-0126.2024.10.014
- VernacularTitle:替罗非班对老年急性前循环颅内动脉粥样硬化性脑卒中机械取栓患者的疗效和安全性
- Author:
Song XU
1
;
Yongtao GUO
;
Mingchao LI
Author Information
1. 223300 南京医科大学附属淮安第一医院神经内科
- Keywords:
anterior circulation;
atherosclerosis;
stent retriever;
tirofiban
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(10):1182-1186
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy and safety of intravenous infusion of tirofiban after mechanical thrombectomy in elderly patients with acute anterior circulation intracranial athero-sclerotic stenosis-related large vessel occlusion(ICAS-LVO).Methods A retrospective analysis was conducted on 106 elderly patients with acute anterior circulation ICAS-LVO undergoing me-chanical thrombectomy in our hospital from June 2021 to August 2023.After operation,38 pa-tients receiving 48-hour intravenous infusion of tirofiban at a drip rate of 0.1 μg/(kg·min)were assigned into experimental group,while the other 68 patients undergoing the infusion for only 24 h served as the control group.The indicators related to efficacy(90-day good prognosis rate)and to safety[intracerebral hemorrhage(ICH),symptomatic intracerebral hemorrhage(sICH),and 90-day mortality rate]were compared between the 2 groups.Multivariate logistic regression model was employed to analyze the influencing factors for good prognosis.Results The experimental group exhibited a significantly higher rate of 90-day favorable prognosis than the control group(52.6％vs 29.4％,P=0.018),but no significant differences were observed in the rates of ICH,sICH,and 90-day mortality between the 2 groups(P＞0.05).Multivariate logistic regression anal-ysis indicated that intravenous tirofiban administration for 48 h(OR=2.554,95％CI:1.067-6.116,P=0.034)and NIHSS score at admission(OR=0.887,95％CI:0.822-0.957,P=0.001)were independent influencing factors for 90-day prognosis in elderly patients undergoing mechani-cal thrombectomy due to acute anterior circulation ICAS-LVO.Conclusion In elderly acute ante-rior circulation ICAS-LVO patients receiving mechanical thrombectomy,postoperative intrave-nous tirofiban infusion for 48 h shows better improvement for 90-day prognosis than for 24 h,and has no effect on increasing the risk of sICH.
