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Tytuł pozycji:

Efficacy and Safety of Low-Dose Tirofiban for Acute Intracranial Atherosclerotic Stenosis Related Occlusion with Residual Stenosis after Endovascular Treatment.

Tytuł:
Efficacy and Safety of Low-Dose Tirofiban for Acute Intracranial Atherosclerotic Stenosis Related Occlusion with Residual Stenosis after Endovascular Treatment.
Autorzy:
Yan Z; Department of Neurosurgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing Jiangsu Province, People's Republic of China; Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Shi Z; Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Wang Y; Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Zhang C; Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Cao J; Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Ding C; Department of Neurosurgery, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Qu M; Department of Radiology, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Xia Y; Department of Radiology, The 904th Hospital of the Joint Logistics Support force of Chinese People's Liberation Army, Wuxi Jiangsu Province, People's Republic of China.
Cai J; Department of Neurosurgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing Jiangsu Province, People's Republic of China.
Zhang X; Department of Neurosurgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing Jiangsu Province, People's Republic of China. Electronic address: .
Wang H; Department of Neurosurgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing Jiangsu Province, People's Republic of China. Electronic address: .
Źródło:
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Apr; Vol. 29 (4), pp. 104619. Date of Electronic Publication: 2020 Jan 22.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
MeSH Terms:
Endovascular Procedures*/adverse effects
Endovascular Procedures*/mortality
Brain Ischemia/*therapy
Intracranial Arteriosclerosis/*therapy
Platelet Aggregation Inhibitors/*administration & dosage
Stroke/*therapy
Tirofiban/*administration & dosage
Aged ; Aged, 80 and over ; Brain Ischemia/diagnosis ; Brain Ischemia/mortality ; Brain Ischemia/physiopathology ; Disability Evaluation ; Female ; Humans ; Intracranial Arteriosclerosis/diagnosis ; Intracranial Arteriosclerosis/mortality ; Intracranial Arteriosclerosis/physiopathology ; Male ; Middle Aged ; Plaque, Atherosclerotic ; Platelet Aggregation Inhibitors/adverse effects ; Recovery of Function ; Recurrence ; Retrospective Studies ; Risk Factors ; Stroke/diagnosis ; Stroke/mortality ; Stroke/physiopathology ; Time Factors ; Tirofiban/adverse effects ; Treatment Outcome
Contributed Indexing:
Keywords: Acute ischemic stroke; endovascular treatment; glycoprotein IIb/IIIa receptor inhibitor; large vessel occlusion
Substance Nomenclature:
0 (Platelet Aggregation Inhibitors)
GGX234SI5H (Tirofiban)
Entry Date(s):
Date Created: 20200127 Date Completed: 20200720 Latest Revision: 20200720
Update Code:
20240104
DOI:
10.1016/j.jstrokecerebrovasdis.2019.104619
PMID:
31982305
Czasopismo naukowe
Background: The optimal treatment strategy for residual stenosis in patients with acute intracranial atherosclerotic stenosis related occlusion (ICAS-O) after endovascular treatment (EVT) is unknown. This study aims to evaluate the efficacy and safety of low-dose tirofiban in patients with residual stenosis after EVT due to acute ICAS-O.
Methods: Retrospective analysis of prospectively enrolled consecutive patients with residual stenosis after EVT due to acute ICAS-O from March 2015 to May 2019. Patients were divided into EVT alone group or EVT plus tirofiban group. The primary endpoint was the favorable functional outcome (defined as modified Rankin scale score of 0-2) at 90 days. The secondary endpoints were the proportions of reocclusion of recanalized arteries within 72 hours after EVT, symptomatic intracranial hemorrhage (sICH), any ICH, and mortality at 90 days. Logistic regression for predictors of reocclusion and functional outcomes were performed.
Results: A total of 98 patients, 50 treated with tirofiban and 48 without tirofiban, were enrolled in this study. Compared with patients in EVT alone group, patients in EVT plus tirofiban group had higher favorable functional outcome rate, lower mortality, and a lower reocclusion rate (56.3% versus 30.4%; P = .014, 8.3% versus 28.3%; P = .016, and 10.4% versus 32.6%; P = .011, respectively). The rates of any ICH and sICH were similar between the 2 groups. The use of tirofiban was associated with the favorable functional outcome (odds ratio [OR], 3.417; 95% confidence interval [CI], 1.149-10.163; P = .027) and lower reocclusion rate (OR, 0.145; 95% CI, 0.038-0.546; P = .004) on multivariate logistic regression analysis.
Conclusions: In patients with residual stenosis after EVT due to acute ICAS-O, a low-dose of tirofiban is associated with favorable functional outcome and reduced incidence of reocclusion without increasing any ICH and sICH.
Competing Interests: Declaration of Competing Interest The authors do not have any conflicts of interest to declare.
(Copyright © 2019 Elsevier Inc. All rights reserved.)

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