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Safety and efficacy of tirofiban treatment in the endovascular treatment of patients with acute ischaemic stroke - A meta-analysis.
Li, Wei; Wang, Kangmeng; Zeng, Chaokun; Huang, KaiLai; Fu, YuSi; Zhao, Zhenqiang.
Afiliación
  • Li W; Department of Neurology，The First Affiliated Hospital of Hainan Medical University, Hainan province, China.
  • Wang K; Department of Neurology，The First Affiliated Hospital of Hainan Medical University, Hainan province, China.
  • Zeng C; Department of Neurology，The First Affiliated Hospital of Hainan Medical University, Hainan province, China.
  • Huang K; Department of Neurology，The First Affiliated Hospital of Hainan Medical University, Hainan province, China.
  • Fu Y; Department of Neurology，The First Affiliated Hospital of Hainan Medical University, Hainan province, China.
  • Zhao Z; Department of Neurology，The First Affiliated Hospital of Hainan Medical University, Hainan province, China. Electronic address: hy0203106@hainmc.edu.cn.
Clin Neurol Neurosurg ; 243: 108330, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38936178
ABSTRACT
OBJECT The use of endovascular therapy (EVT) has become a widespread strategy for the clinical management of acute ischemic stroke (AIS). However, the combination of arterial injection of tirofiban with EVT for AIS continues to be a subject of controversy. This meta-analysis was conducted to assess the safety and efficacy of this treatment approach.

METHODS:

Relevant studies were identified through a systematic literature search in Pubmed, EMBASE, Web of Science, and Cochrane Library databases, covering articles published from January 2010 to January 2023. The efficacy outcomes included favorable functional outcomes, recanalization rates, and safety outcomes including mortality and symptomatic intracranial hemorrhage (sICH).

RESULTS:

The meta-analysis consisted of data from 13 studies, which included 1 randomized controlled trial (RCT), 7 prospective cohort studies, and 5 retrospective cohort studies, encompassing a total of 3477 patients. The study results indicate that the intra-arterial (IA) tirofiban+EVT for AIS is associated with significant improvements in favorable functional outcomes (OR, 1.21; 95%CI, 1.05-1.40; P = 0.009) and recanalization rate (OR, 1.33; 95%CI, 1.06-1.65; P = 0.01), as well as significant reductions in mortality rates (OR, 0.65; 95%CI, 0.53-0.79; P = 0.0001). Subgroup analysis revealed that administering a maintenance dose of intravenous (IV) tirofiban post-EVT was significantly associated with improved functional outcomes and reduced mortality in patients. In addition, there was no increase in the incidence of sICH (OR, 0.92; 95%CI, 0.71-1.20; P = 0.54).

CONCLUSION:

The administration of Intra-arterial tirofiban combined with EVT is an effective and safe treatment strategy for AIS, and postoperative maintenance doses of intravenous tirofiban may be more effective than IA only.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Endovasculares / Tirofibán / Accidente Cerebrovascular Isquémico Límite: Humans Idioma: En Revista: Clin Neurol Neurosurg Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Endovasculares / Tirofibán / Accidente Cerebrovascular Isquémico Límite: Humans Idioma: En Revista: Clin Neurol Neurosurg Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos