Efficacy and safety of tirofiban in the bridging therapy of mechanical thrombectomy after intravenous thrombolysis for acute ischemic stroke with main artery occlusion

Objective To evaluate the efficacy and safety of tirofiban in the bridging therapy of mechanical thrombectomy after intravenous thrombolysis for acute ischemic stroke with main artery occlusion. Methods A retrospective analysis was performed using clinical data from 121 patients who were admitted into Nanjing Hospital Affiliated to Nanjing Medical University from January 2016 to January 2019.The patients received bridging therapy due to acute ischemic stroke with main artery occlusion,including 45 patients treated with tirofiban during and after thrombectomy（a tirofiban group）,and 76 patients without use of tirofiban（a standard treatment group）.Both groups were compared for baseline data,the scores of the National Institutes of Health Stroke Scale（NIHSS） 24 h and 7 days after thrombectomy,the Modified Rankin Score（mRS） scores on Days 30 and 90,the blood flow grades of modified thrombolysis in myocardial infarction（mTICI） after thrombectomy,vascular re-occlusion rate,the incidence of symptomatic intracranial hemorrhage（SICH）,the incidence of gastrointestinal hemorrhage and 3-month mortality to assess the efficacy and safety of the two treatment options. Results Compared with the standard treatment group,the tirofiban group showed remarkable improvements in blood flow grades,7-day NIHSS scores,30-day mRS scores and 90-day mRS scores and vascular reocclusion rate（P＜0.05）.Meanwhile,no statistical difference was found in SICH incidence,gastrointestinal hemorrhage incidence and 3-month mortality rate between the two groups（P＞0.05）.Conclusions The use of tirofiban during and after the bridging therapy in acute ischemic stroke patients with main artery occlusion can improve vascular reperfusion,improve the prognosis and reduce the rate of vascular reocclusion without increasing the risk of bleeding.