Prophylactic administration of tirofiban prevents ischemic events in endovascular treatment of unruptured intracranial aneurysms

被引：0

作者：

Jinbiao Yao ^{[1
]}

Yangyang Zhou ^{[2
]}

Ruhang Xie ^{[1
]}

Chao Wang ^{[2
]}

Yongnan Zhu ^{[1
]}

Wenqiang Li ^{[2
]}

Ying Zhang ^{[1
]}

机构：

[1] Capital Medical University,Department of Interventional Neuroradiology, Beijing Neurosurgical Institute

[2] Capital Medical University,Neurosurgery, Beijing Tiantan Hospital

[3] Beijing Geriatric Hospital,Neurosurgery

来源：

Neurosurgical Review | / 48卷 / 1期

关键词：

Intracranial aneurysm; Flow diverter; Ischemic event; Tirofban; Endovascular treatment; Stent;

D O I：

10.1007/s10143-025-03601-2

中图分类号：

学科分类号：

摘要：

Background: Stents-assisted coiling (SAC) and flow diverters (FD) are widely used in the endovascular treatment of intracranial aneurysms. However, due to the thrombogenicity of metallic implants, their application may increase the risk of ischemic events. This study aims to evaluate the efficacy of prophylactic tirofiban with dual antiplatelet treatment (DAPT) in unruptured intracranial aneurysms (UIA) patients treated with SAC or FD. Methods: This single center retrospective study included patients with UIAs treated with SAC or FD. Data collected included demographic information, imaging findings, laboratory results, and perioperative complications. Multivariate logistic regression analysis was used to identify independent risk factors for ischemic events. Patients were stratified based on these risk factors, and the efficacy of tirofiban was evaluated across different risk groups. Results: A total of 420 patients were included in the study, of whom 22(5.2%) experienced ischemic events. Among them, eight patients (3.3%) were in the tirofiban group and 14 patients (8.0%) were in the DAPT (non-tirofiban) group. Multivariate logistic regression identified independent risk factors for ischemic events, including posterior circulation aneurysm (OR: 2.87, 95% CI: 1.06–7.78; P = 0.038) and diabetes (OR: 4.05, 95% CI: 1.50–10.96; P = 0.006). The prophylactic use of tirofiban combined with DAPT can effectively reduce postoperative ischemic events (OR: 0.35, 95% CI: 0.14–0.91; P = 0.032) without increasing the risk of hemorrhage. Conclusion: This study demonstrates that prophylactic use of tirofiban can effectively reduce postoperative ischemic events in UIA patients receiving SAC or FD treatments without increasing the risk of hemorrhage.

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