Intra-arterial infusion of tirofiban and urokinase for thromboembolic complications during coil embolization of ruptured intracranial aneurysms.

AIM

To investigate the effectiveness and safety of intra-arterial tirofiban and urokinase for thromboembolic complications during detachable coil treatment of ruptured intracranial aneurysms.

MATERIAL AND METHODS

Fourteen patients who had a thromboembolic complication during detachable coil treatment of ruptured cerebral aneurysms from May 2011 to October 2013 were enrolled in this study. Within one hour of thrombus formation, patients underwent intra-arterial infusion of tirofiban plus urokinase with digital subtraction angiography monitoring. Blood flow was checked every 5 min with angiography until complete or partial recanalization of the occluded artery occurred.

RESULTS

Of the 14 patients, 10 exhibited complete recanalization immediately after the thrombolytic treatment, and had no neurological dysfunction except one patient with mild hemiplegia. Two patients with partial recanalization exhibited mild neurological dysfunction and one died of cardiac infarction during the recovery period. Two patients had intracranial hemorrhage. In one of these, this was caused by rupture of the aneurysm and the patient died during the thrombolytic treatment. In the remaining patient, intracranial hemorrhage was caused by a puncture of the left posterior internal frontal artery caused by mechanical thrombolysis.

CONCLUSION

Intra-arterial administration of tirofiban plus urokinase is an effective and safe treatment for thromboembolism during detachable coil treatment of ruptured intracranial aneurysms.