Kang Hyun-Seung, Kwon Bae Ju, Roh Hong Gee, Yoon Sung Won, Chang Hyuk Won, Kim Jeong Eun, Han Moon Hee
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
Neurosurgery. 2008 Aug;63(2):230-7; discussion 237-8. doi: 10.1227/01.NEU.0000320440.85178.CC.
Thromboembolism is one of the most common and serious complications associated with the endovascular embolization of intracranial aneurysms. We report our clinical experiences with intra-arterial tirofiban infusion during aneurysm embolization.
The clinical, radiological, and laboratory data of 24 patients harboring 25 aneurysms (25 procedures) who underwent intra-arterial tirofiban infusion for thromboembolism during the endovascular treatment of intracranial aneurysms were reviewed retrospectively. Thrombi or emboli were resolved by superselective intra-arterial tirofiban infusion via a microcatheter.
The study cohort comprised 14 unruptured and 11 ruptured aneurysms. Intra-arterially infused tirofiban doses ranged from 0.2 to 1.0 mg (mean +/- standard deviation, 0.64 +/- 0.25 mg). Thromboemboli were resolved, and arteries were recanalized on all occasions except one: a case of distal middle cerebral artery embolism. No hemorrhagic complications related to intra-arterial tirofiban infusion occurred.
Intra-arterial tirofiban delivery appears to be a safe and effective treatment modality when thromboembolism is encountered during the endovascular treatment of intracranial aneurysms.
血栓栓塞是颅内动脉瘤血管内栓塞术相关的最常见且严重的并发症之一。我们报告在动脉瘤栓塞过程中动脉内输注替罗非班的临床经验。
回顾性分析24例（共25个动脉瘤，行25次手术）在颅内动脉瘤血管内治疗期间因血栓栓塞接受动脉内替罗非班输注患者的临床、影像学和实验室数据。通过微导管超选择性动脉内输注替罗非班溶解血栓或栓子。
研究队列包括14个未破裂动脉瘤和11个破裂动脉瘤。动脉内输注替罗非班的剂量为0.2至1.0毫克（平均±标准差，0.64±0.25毫克）。除1例大脑中动脉远端栓塞外，所有病例的血栓栓子均溶解，动脉再通。未发生与动脉内输注替罗非班相关的出血并发症。
在颅内动脉瘤血管内治疗过程中遇到血栓栓塞时，动脉内输注替罗非班似乎是一种安全有效的治疗方式。
