Intra arterial tirofiban as rescue therapy during mechanical thrombectomy in stroke may improve recanalization rates

For this purpose, they conducted a retrospective study among AIS patients with LVO eligible for endovascular revascularization and in whom IA tirofiban is given as rescue therapy.

IA tirofiban at a dose of 0.4 μg/kg/min was administered through the microcatheter in the target vessel followed by intravenous (IV) infusion of 0.1 μg/kg/min if the target vessel shows reocclusion following initial recanalization, flow limiting or significant residual stenosis after thrombectomy, or requires balloon angioplasty or stenting. The study's primary safety measure was the incidence of symptomatic haemorrhage.

There were 82 patients in the study; 36 were in the tirofiban group, and 46 were in the non-tirofiban group.

The study led to the following findings:

• Immediate successful reperfusion was achieved in 86.1% of patients and 89% of patients in the tirofiban and non-tirofiban groups, respectively.
• 19.4 and 25% of patients in the tirofiban group required adjunct techniques of angioplasty and stenting, respectively.
• 2.7% of patients in the tirofiban group had a symptomatic haemorrhage, while 8.7% in the non-tirofiban group had symptomatic intracranial haemorrhage.
• On multinomial logistic regression, a history of transient ischemic attack, watershed infarct pattern, and truncal occlusion predicted the usage of IA tirofiban during mechanical thrombectomy.

"The findings revealed that using IA tirofiban with or without other adjunct techniques as rescue therapy during MT in LVO improved recanalization rates without raising symptomatic haemorrhage risk," the researchers concluded.

Reference:

The study titled, "Safety Profile of Intra-Arterial Tirofiban as a Rescue Therapy during Mechanical Thrombectomy in Acute Ischemic Stroke," was published online in the Journal of Clinical Interventional Radiology. DOI: 10.1055/s-0043-1775981