关键词: 替罗非班; 颅内动脉瘤; 支架辅助栓塞; 血栓形成; 围手术期

Abstract: Objective To investigate the efficacy and safety of tirofiban in treatment of periprocedural in-stent thrombosis during stent-assisted coiling of intracranial aneurysms. Methods This retrospective analysis enrolled the patients with perioprocedural in-stent thrombosis during stent-assisted coiling for intracranial aneurysms at Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from June 2018 to December 2020. The clinical data of all the patients were analyzed to evaluate the efficacy and safety of tirofiban for periprocedural thrombosis, and the assessment indexes included the thrombus dissolution rate, periprocedural bleeding and mRS score at discharge. Results Of 177 patients who underwent stent-assisted coil embolization, 12 cases (6.8%) had periprocedural thrombotic events, with a median age of 56.5 years and 11 (91.7%) females, including 10 cases (83.3%) with anterior circulation aneurysms and 2 cases (16.7%) with posterior circulation aneurysms, all of which were unruptured aneurysms. Laser sculpting stents were used in 4 cases (33.3%) and braided stents were used in 8 cases (66.7%). Intraprocedural thrombotic events occurred in 9 cases (85.0%), and postprocedural thrombotic events occurred in 3 cases (15.0%). After the application of tirofiban, the thrombus was successfully dissolved in all 12 patients. Only one patient had an intracerebral hemorrhage after using tirofiban, and this patient had a poor prognosis (mRS 4 points) at discharge, and the remaining 11 patients (91.7%) had no complication and they all had a good prognosis (all mRS 0 point). Conclusions The application of tirofiban is a safe and effective treatment for periprocedural instent thrombosis during stent-assisted coiling of intracranial aneurysms.

Key words: Tirofiban; Intracranial aneurysm; Stent-assisted embolization; Thrombosis;Periprocedural