Acute Stenting and Concomitant Tirofiban Administration for the Endovascular Treatment of Acute Ischemic Stroke Related to Intracranial Artery Dissections: A Single Center Experience and Systematic Review of the Literature.
Administration, Intravenous
Adult
Aged
Aortic Dissection
/ complications
Endovascular Procedures
/ adverse effects
Female
Humans
Intracranial Aneurysm
/ complications
Ischemic Stroke
/ diagnostic imaging
Male
Middle Aged
Platelet Aggregation Inhibitors
/ administration & dosage
Retrospective Studies
Stents
Time Factors
Tirofiban
/ administration & dosage
Treatment Outcome
Vascular Patency
Young Adult
Interventional neuroradiology
Intracranial dissection
Intracranial stent
Stroke
Tirofiban
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
30
12
2020
revised:
29
04
2021
accepted:
08
05
2021
pubmed:
6
6
2021
medline:
27
7
2021
entrez:
5
6
2021
Statut:
ppublish
Résumé
Intracranial artery dissection is an uncommon cause of acute ischemic stroke. Although acute stenting of the dissected arterial segment is a therapeutic option, the associated antiplatelet regimen remains a matter of debate. To evaluate the efficacy and safety of acute intracranial stenting together with concomitant intravenous administration of tirofiban and to perform a systematic review of the literature. A single-center, retrospective study of the clinical and radiological records of all patients treated at our center by intracranial stenting in the setting of acute ischemic stroke between January 2010 and December 2020. A systematic review of the literature was conducted according to the PRISMA-P guidelines for relevant publications from January 1976 to December 2020 on intracranial artery dissection treated by stent. Seven patients with intracranial artery dissections underwent acute stenting with concomitant tirofiban during the study period. Mid-term follow-up showed parent artery patency in 6/7 cases (85.7%). The modified Rankin Score was ≤ 0-2 at 3 months in 5/7 cases (71.4%). The literature review identified 22 patients with intracranial artery dissection treated with acute stenting in association with different antithrombotic therapies. Complete revascularization was obtained in 86.3% of cases with a modified Rankin Score of ≤ 0-2 in 68% of patients at 3-month follow-up. Acute intracranial stenting together with intravenous tirofiban administration could be a therapeutic option in patients with intracranial artery dissection and a small ischemic core.
Sections du résumé
BACKGROUND
BACKGROUND
Intracranial artery dissection is an uncommon cause of acute ischemic stroke. Although acute stenting of the dissected arterial segment is a therapeutic option, the associated antiplatelet regimen remains a matter of debate.
OBJECTIVES
OBJECTIVE
To evaluate the efficacy and safety of acute intracranial stenting together with concomitant intravenous administration of tirofiban and to perform a systematic review of the literature.
MATERIALS AND METHODS
METHODS
A single-center, retrospective study of the clinical and radiological records of all patients treated at our center by intracranial stenting in the setting of acute ischemic stroke between January 2010 and December 2020. A systematic review of the literature was conducted according to the PRISMA-P guidelines for relevant publications from January 1976 to December 2020 on intracranial artery dissection treated by stent.
RESULTS
RESULTS
Seven patients with intracranial artery dissections underwent acute stenting with concomitant tirofiban during the study period. Mid-term follow-up showed parent artery patency in 6/7 cases (85.7%). The modified Rankin Score was ≤ 0-2 at 3 months in 5/7 cases (71.4%). The literature review identified 22 patients with intracranial artery dissection treated with acute stenting in association with different antithrombotic therapies. Complete revascularization was obtained in 86.3% of cases with a modified Rankin Score of ≤ 0-2 in 68% of patients at 3-month follow-up.
CONCLUSIONS
CONCLUSIONS
Acute intracranial stenting together with intravenous tirofiban administration could be a therapeutic option in patients with intracranial artery dissection and a small ischemic core.
Identifiants
pubmed: 34090173
pii: S1052-3057(21)00294-9
doi: 10.1016/j.jstrokecerebrovasdis.2021.105891
pii:
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Tirofiban
GGX234SI5H
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
105891Informations de copyright
Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.