This meta-analysis aims to evaluate the use of Tirofiban as an adjunct therapeutic agent during Mechanical Thrombectomy.

Tirofiban is a newer Antiplatelet agent belonging to the glycoprotein IIb/IIIa receptors. Currently, Tirofiban is used  in acute thrombotic cardiac events. It also finds its use as an adjunct drug along with Heparin and Aspirin in Mechanical Thrombectomy although data regarding the same is conflicting.

A comprehensive search of major medical databases was performed up until July 2024 and relevant articles were identified. The primary outcome of interest was 90-day mortality and secondary outcome was Symptomatic Intracranial Hemorrhage (SICH) and reperfusion success rate .Statistical analysis was conducted in R studio and the risk ratios were estimated by the Mantel-Haenszel method and Inverse variance method . I2 tests were used to test the heterogeneity and determine the analysis model. Further subgroup analysis was done based on the route of the administration of the drug. 

The conducted meta-analysis included a total of 22 studies with 3 subgroups  based on administration routes of Tirofiban - intravenous (IV), intra arterial (IA) and combination of IV and IA. The risk of 90 day mortality was lower in the tirofiban group (RR = 0.78 (0.70-0.86) ; 95% CI, p < 0.010), with the effect being most pronounced in the IV + IA group. The usage of tirofiban resulted in the reduction of development of SICH ( RR = 0.90 (0.77 - 1.06 ) ; 95% CI , p = 0.05) and improved success in reperfusion rates (RR = 1.03 (1.01 - 1.16) ; 95% CI, p = 0.02). 

Our analysis indicates lower mortality rates when Tirofiban is used as adjunctive therapy with mechanical thrombectomy. More studies are required to confirm these findings and optimise the usage of tirofiban as an adjunctive therapeutic agent in mechanical thrombectomy.