Abstract Details

Title Tirofiban and Endovascular Treatment Versus Endovascular Treatment in Patients with Intracranial Artery Atherosclerosis: A Meta-Analysis of 3,179 Patients.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - Innovations in Cerebrovascular Therapy (5:06 PM-5:18 PM)

Poster/Presentation
Number 009

Objective

We performed a meta-analysis to evaluate the efficacy and safety of tirofiban in patients with LVO-A.

Background Endovascular treatment (EVT) is the modality of treatment in select patients with acute ischemic stroke due to large vessel occlusion secondary to atherosclerosis (LVO-A). About 30 % of patients don't achieve successful following endovascular treatment. The adjunctive use of selective glycoprotein IIb/IIIa receptor antagonists, such as Tirofiban, has been shown to improve reperfusion rates following EVT. However, their use in LVO-A is relatively limited.

Design/Methods

A database search was conducted until July 2024, to identify published studies that compare the use of Tirofiban in LVO-A to a control group. Prophylactic use refers to preventing secondary occlusion. Rescue refers to the use in a patient with unsuccessful reperfusion. The main outcomes assessed included 90-day reocclusion, 90-day mortality, and 90-day favorable modified Rankin Scale (mRS) score (0-2).

Results

From a total of 1,438 studies, 2 randomized controlled trials and 10 cohorts were included, encompassing a population of 3,179 patients. We found that prophylactic administration of tirofiban significantly reduced the risk of mortality (Risk ratio [RR]=0.65, 95%CI: 0.44-0.95, p=0.03). Both prophylactic and rescue tirofiban administration reduced 90-day mortality (RR=0.74, 95%CI: 0.63-0.87, p=0.002). Rescue Tirofiban was associated with a higher rate of favorable 90-day mRS (RR=2.52, 95%CI: 1.07-5.92, p=0.03) and lower risk of reocclusion (RR=0.58, 95%CI:0.34-0.97, p=0.04) at 90 days.

Conclusions Our findings suggest that tirofiban is an effective and safe treatment for improving clinical outcomes in patients with LVO-A. Large multicentric clinical trials are necessary to evaluate the patients that can benefit from the adjunct use of Tirofiban.

Authors/Disclosures
Amiel A. Aragon Cortes PRESENTER	Mr. Aragon Cortes has nothing to disclose.
Luis E. Cueva Cañola, Sr., Medical student	Mr. Cueva Cañola has nothing to disclose.
Dilmareth E. Natera Rodriguez, MD (University of Minnesota)	Miss NATERA RODRIGUEZ has nothing to disclose.
Damaris A. Velarde	Dr. Velarde has nothing to disclose.
Erick Calvario, MD	Dr. Calvario has nothing to disclose.
Yoshua Flores, Sr., MD	Dr. Flores has nothing to disclose.
Ricardo A. Orozco, Med Student	Mr. Orozco has nothing to disclose.
María d. Nevárez Rivera, MD	Dr. Nevárez Rivera has nothing to disclose.
Diego Pichardo-Rojas, MD	Dr. Pichardo-Rojas has nothing to disclose.
Veronica A. Moreno Gomez, MD (Department of Neurology)	Dr. Moreno Gomez has nothing to disclose.

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