Luo Ying, Yang Yang, Xie Yang, Yuan Zhengzhou, Li Xiaogang, Li Jinglun
Department of Neurology, Affiliated Hospital of Southwest Medical University, Sichuan, China.
Interv Neuroradiol. 2019 Dec;25(6):705-709. doi: 10.1177/1591019919851167. Epub 2019 May 21.
The objective of this study was to investigate and discuss the therapeutic effect of pre-operative tirofiban on patients with acute ischemic stroke (AIS) with mechanical thrombectomy (MT) within 6-24 h.
We retrospectively queried our AIS database from January to November 2018, and selected 99 patients with AIS within 6-24 h and evidence of proximal large vessel occlusion who were suitable for MT. They were divided into two groups, group A (with tirofiban, = 56) and group B (without tirofiban, = 43), according to whether they were intravenously infused with tirofiban before MT. The baseline characteristics and outcomes of patients were subjected to statistical analysis, including age, gender and risk factors, occlusion site, the time from onset to door, time of door to puncture, baseline National Institutes of Health Stroke Scale (NIHSS), pre-operative Alberta stroke programme early CT (ASPECT) score, angioplasty/stenting, modified Rankin Scale score 0-2 at 3 months, symptomatic haemorrhage and mortality, the time of door to recanalization, endovascular procedure time, 7-day (7d) NIHSS score, and a modified treatment in cerebral infarction (m-TICI) grade of 2b or 3. All of the thrombi were analysed by histopathology.
The differences in the time of door to recanalization, endovascular procedure time, 7d NIHSS score and the m-TICI were significantly different between groups ( < 0.05). The other agents were not significantly different between groups ( > 0.05 each). Histopathological analysis showed that all thrombi contained different amounts of platelets, fibrinogen, Haemamoebas and red blood cells.
The use of tirofiban before MT can shorten the procedure time and improve the recanalization rate of occluded vessels in AIS patients.
本研究旨在探讨和讨论术前替罗非班对6 - 24小时内行机械取栓术（MT）的急性缺血性卒中（AIS）患者的治疗效果。
我们回顾性查询了2018年1月至11月的AIS数据库，选取了99例发病6 - 24小时、有近端大血管闭塞证据且适合MT的AIS患者。根据MT术前是否静脉输注替罗非班，将他们分为两组，A组（使用替罗非班，n = 56）和B组（未使用替罗非班，n = 43）。对患者的基线特征和结局进行统计分析，包括年龄、性别和危险因素、闭塞部位、发病至入院时间、入院至穿刺时间、基线美国国立卫生研究院卒中量表（NIHSS）评分、术前阿尔伯塔卒中项目早期CT（ASPECT）评分、血管成形术/支架置入术、3个月时改良Rankin量表评分0 - 2、症状性出血和死亡率、入院至再通时间、血管内手术时间、7天（7d）NIHSS评分以及改良脑梗死治疗（m - TICI）2b或3级。所有血栓均进行组织病理学分析。
两组在入院至再通时间、血管内手术时间、7d NIHSS评分和m - TICI方面差异有统计学意义（P < 0.05）。其他指标两组间差异无统计学意义（各P > 0.05）。组织病理学分析显示，所有血栓均含有不同数量的血小板、纤维蛋白原、血变形虫和红细胞。
MT术前使用替罗非班可缩短手术时间，提高AIS患者闭塞血管的再通率。
