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颅内动脉粥样硬化相关闭塞局部注射替罗非班的长期疗效

Long-Term Outcomes of Local Tirofiban Infusion for Intracranial Atherosclerosis-Related Occlusion.

作者信息

Choi Woochan, Hwang Yang-Ha, Kim Yong-Won

机构信息

Department of Neurology, Kyungpook National University Hospital, Daegu 41944, Korea.

Department of Neurology, School of Medicine, Kyungpook National University, Daegu 41944, Korea.

出版信息

Brain Sci. 2022 Aug 17;12(8):1089. doi: 10.3390/brainsci12081089.

Abstract

Local tirofiban infusion has been reported as a rescue strategy for intracranial atherosclerotic stenosis (ICAS)-related stroke. However, the long-term outcomes of local tirofiban infusion during endovascular reperfusion therapy (ERT) for ICAS-related stroke are still uncertain. This study aimed to investigate the long-term outcomes of local tirofiban infusion during ERT. We retrospectively analyzed acute patients with ICAS-related stroke who were treated with local tirofiban as a rescue strategy during ERT. The primary outcomes were ischemic stroke, transient ischemic stroke (TIA), and stroke-related death within 30 days. Secondary outcomes included ischemic stroke and TIA beyond 30 days and up to 2 years after ERT in the corresponding treated vessel, symptomatic brain hemorrhage, any stroke, and non-stroke-related death. During a median follow-up of 24.0 months, 12 patients developed an ischemic stroke and TIA (4 within 30 days and 8 afterward). The 1-year risk of stroke and TIA was 9.2% (95% confidence interval, 8.0-18.6%). This study demonstrates that 1-year outcomes of local tirofiban infusion were comparable to the results of intracranial stenting in patients with symptomatic ICAS. Local tirofiban infusion for ICAS-related stroke may be a feasible rescue strategy that can have a bridging role until the maximum effect of antiplatelet agents is achieved.

摘要

局部注射替罗非班已被报道为颅内动脉粥样硬化狭窄(ICAS)相关卒中的一种挽救策略。然而,在ICAS相关卒中的血管内再灌注治疗(ERT)期间局部注射替罗非班的长期疗效仍不确定。本研究旨在调查ERT期间局部注射替罗非班的长期疗效。我们回顾性分析了在ERT期间接受局部注射替罗非班作为挽救策略的ICAS相关卒中急性患者。主要结局为30天内的缺血性卒中、短暂性脑缺血发作(TIA)和卒中相关死亡。次要结局包括ERT后30天以上至2年内在相应治疗血管内发生的缺血性卒中和TIA、症状性脑出血、任何卒中以及非卒中相关死亡。在中位随访24.0个月期间,12例患者发生了缺血性卒中和TIA(30天内4例,之后8例)。卒中及TIA的1年风险为9.2%(95%置信区间,8.0 - 18.6%)。本研究表明,对于有症状的ICAS患者,局部注射替罗非班的1年疗效与颅内支架置入术的结果相当。局部注射替罗非班治疗ICAS相关卒中可能是一种可行的挽救策略,在抗血小板药物达到最大疗效之前可起到桥梁作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9672/9406202/7cc0fa0a6b17/brainsci-12-01089-g001.jpg

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