Low-dose intravenous tirofiban infusion after endovascular recanalization for non-acute middle cerebral artery occlusion.

Background and purpose: Endovascular recanalization for patients with symptomatic non-acute middle cerebral artery occlusion still remines challenging. Postoperative treatment is still controversial. This study aims to investigate the safety and effectiveness of tirofiban after elective angioplasty in patients with non-acute middle cerebral artery occlusion related ischemic stroke. Methods: Our study is a retrospective case series study of 48 stroke patients who received elective endovascular recanalization for middle cerebral artery occlusion. Patients who received EVT without hemorrhage were divided into 2 groups: those who did not receive intravenous tirofiban treatment (control group, n = 25); those who received continuous intravenous infusion of 0.2-0.3 mg/h tirofiban for 48 h after endovascular recanalization (intravenous tirofiban group, n = 23). Early reocclusion of treated arteries, symptomatic hemorrhage, and 90-day functional outcome of the 2 groups were compared. Results: The 90-day mRS score and NIHSS score after endovascular recanalization showed no significantly different between the two groups. However, the rate of mRS score reverse (≥1) was significantly higher in the intravenous tirofiban group than the control (73.9% versus 24.0%, P = 0.001), and the rate of NIHSS score reverse (≥3) in the intravenous tirofiban group was also higher (43.5% verse 16.0%, P = 0.037). The rate of early reocclusion, symptomatic hemorrhage (4.3% versw 4%, P = 0.734), showed no difference between the two groups. Conclusions: Low-dose intravenous tirofiban infusion (0.2-0.3 mg/h for 48 h) after endovascular treatment seems to be safe and potentially effective for non-acute middle cerebral artery occlusion patients.