The Retrospective Analysis Of Intravenous Using Tirofiban Lonely For Clinical Application In Stent-assisted Embolization Of Intracranial Aneurysms

Objective:Ischemic event is one of the main complications of interventional therapy for intracranial aneurysms.The purpose of this study was to assess the efficacy and safety of intravenous using tirofiban alone in the prevention of ischemic events in stent-assisted intracranial aneurysm embolization.Materials and methods:Collected from January 2016 to December 2017,275 patients with stent-assisted intracranial aneurysm embolization in our hospital were selected according to certain criteria for inclusion and exclusion.they were divided into two groups according to whether the different antiplatelet strategies on preoperation: control group(n=124,ruptured aneurysms with loading dose of dual antiplatelet)and experimental group(n=151,ruptured aneurysms with intravenous tirofiban strategy).experimental group is intravenous tirofiban strategy(intravenous administration of tirofiban 4μg/kg over 3 min followed by a maintenance dose of 0.15μg/kg/min,totally 24h).Gender,age,location and size of aneurysm,preoperative Hunt-Hess classification,and m RS scores at discharge and 3 months postoperatively were recorded to assess whether there were significantly fifference between the two treatment groups.Case of intracranial hemorrhage or ischemic events were recorded.m RS scores at discharge and 3 months postoperatively were used to evaluate the difference of the groups.Statistical analysis was performed using the SPSS version 19.0 software(SPSS,IL,USA).Continuous data were presented in means ± standard deviation if it is normal distribution and the independent samples t test was used for comparing continuous data.Categorical data was presented in proportions and the Pearson Chi-square(χ2)test or Fisher’s exact test for comparing categorical data.The P values were all two-sided,and a P value ? 0.05 was considered statistically significant.Result:(1)Gender,age,location and size of aneurysm,preoperative Hunt-Hess classification,and m RS scores at discharge and 3 months postoperatively were no significantly fifference between the two treatment groups(P > 0.05).(2)Ischemic events were fewer in the experimental group(7/151,4.6%)compared with the control group(16/124,12.6%,P=0.013),and intracranial hemorrhages were lower in the experimental group(2/151,1.3%)than the control group(2/124,1.6%,P>0.05).Conclusion:(1)Intravenous using tirofiban alone versus loading dose of dual antiplatelet in preventing ischemic events by stent-assisted coiling of intracranial aneurysms is safe and effiency,with a reduction of the rate of ischemic events and without increase of the incidence of bleedings.(2)Regardless of the different antiplatelet therapy,there was no significantly difference in m RS assessment between the patients at the same stage postoperatively.