Safety and Efficacy of Intra-arterial Tirofiban Injection During Mechanical Thrombectomy for Large Artery Occlusion
Safety and Efficacy of Intra-arterial Tirofiban Injection During Mechanical Thrombectomy for Large Artery Occlusion
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DOI：
10.2174/1567202616666191023154956
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发表时间：
2019-01-01
影响因子：
2.1
通讯作者：
Lee, Dong H.
中科院分区：
文献类型：
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作者：
Yi, Ho J.;Sung, Jae H.;Lee, Dong H.
目的：研究糖蛋白IIb/IIIa抑制剂替罗非班在支架取出器机械取栓(MT)中的安全性和有效性。方法：2015年1月至2019年5月，327例大动脉闭塞(LAO)患者接受机械取栓术。将患者分为两组：MT+IA替罗非班组(MTO组)和MT组(MTO+IA替罗非班组)。通过比较四甲基偶氮唑盐(MTO)组和四甲基偶氮唑盐(MTO)组的临床结果、放射学结果和各种并发症，如血栓摘除后出血、症状性出血、其他全身出血、脑梗塞出血性转化等。对静脉注射组织型纤溶酶原激活剂(t-PA)行MT的患者进行亚组分析。结果：MTO组支架置入次数和再闭塞率均低于MTO组(P分别为0.038和0.022)。两组在血栓摘除后出血、症状性出血、其他全身出血并发症、脑梗塞出血性转化等方面差异无统计学意义(P分别为0.511、0.397、0.429和0.355)。在亚组分析中，观察到类似的结果。结论：在MT期间使用IA替罗非班似乎是安全的，而且可能比只使用IA替罗非班的MT更有效，即使在MT前使用静脉注射t-PA的患者也是如此。
Objective: The safety and effect of intra-arterial (IA) tirofiban, a glycoprote n IIb/IIIa inhibitor, during the stent retriever mechanical thrombectomy (MT) was investigated.Methods: From January 2015 to May 2019, a total of 327 patients underwent mechanical thrombectomy of large artery occlusions (LAO). Patients were classified into two groups: MT with IA tirofiban (MTT) group and MT only (MTO, without IA tirofiban) group. Clinical outcomes, radiological results, and various complications, such as post thrombectomy hemorrhage, symptomatic hemorrhage, other systemic bleeding, and hemorrhagic transformation of infarct were evaluated by comparing the MTT group and MTO group. In addition, subgroup analysis was performed for patients who underwent MT with prior intravenous (IV) tissue plasminogen activator (t-PA).Results: The MTT group needed a lower mean number of stent passes and showed a re-occlusion rate as compared with the MTO group (P=0.038 and 0.022, respectively). Between the two groups, there were no statistically significant differences in post thrombectomy hemorrhage, symptomatic hemorrhage, other systemic bleeding complications, or hemorrhagic transformation of infarct (P = 0.511, 0.397, 0.429, and 0.355, respectively). In the subgroup analysis, similar findings were observed.Conclusion: The use of IA tirofiban during MT seems to be safe and potentially more effective than only MT without IA tirofiban, even in patients who used IV t-PA before MT.