Safety and Efficiency of Low Dose Intra-arterial Tirofiban in Mechanical Thrombectomy During Acute Ischemic Stroke

Objective: In this study, we aimed to evaluate the safety and efficiency of low dose intra- arterial tirofiban in mechanical thrombectomy of acute ischemic stroke patients to facilitate the reperfusion of distal vessel. Methods: We retrospectively analyzed 54 consecutive acute ischemic patients who underwent mechanical thrombectomy for large-vessel occlusion. Patients were divided into two groups based on whether intra-arterial tirofiban was used during mechanical thrombectomy to facilitate the reperfusion of distal vessel. Patients in Non-tirofiban group (n=28) have received mechanical thrombectomy, while Patients in Tirofiban group (n=26) have received mechanical thrombectomy with a low dose intra-arterial tirofiban. We comparatively analyzed two groups of the bleeding complications, recanalization rate, 24-hour National Institutes of Health Stroke Scale score, functional independence of 90 day and mortality rate. Results: Of 54 patients undergoing mechanical thrombectomy, baseline characteristics did not differ between the Tirofiban group and Non-tirofiban cohort. Symptomatic intracranial hemorrhage rates were not different between Tirofiban group and Non-tirofiban group (11.5 % vs. 14.3%). Total 47 (87.0%) patients have realized successful recanalization, no apparent difference between two groups (85.7% vs. 88.5%, P>0.05). Mean 24-hour National Institutes of Health Stroke Scale score was 9.24±6.85, 9.11±8.13 in the Non-tirofiban group and 9.39±5.31 in the Tirofiban group respectively, P>0.05. Total 20 (35.7%) patients have achieved functional independence (34.6% vs. 39.3%, P>0.05) at 90 days. Patients treated with tirofiban presented lower mortality when compared with those who were not treated with tirofiban without significant difference (10.7% versus 3.8%, P>0.05). Conclusion: Intra-arterial tirofiban may be safe in mechanical thrombectomy of acute ischemic stroke to facilitate the reperfusion of distal vessel, but has no beneficial effect on prognosis.