Evidence map›Paper›PMID 40824386›Full record

SynthesisClinical neuroradiology2025

Intravenous Tirofiban for Preventing Acute In-Stent Thrombosis in Emergent Carotid Artery Stenting: a Systematic Review and Meta-Analysis.

Anderson Matheus Pereira da Silva, Ocílio Ribeiro Gonçalves, Mariana Lee Han, Filipe Virgilio Ribeiro, Luciano Falcão, Victor Arthur Ohannesian, Mariana Letícia de Bastos Maximiano, Christian Ken Fukunaga, Lucca Tamara Alves Carretta, Ricardo Fonseca Oliveira Suruagy-Motta and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Clinical neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Letter to the Editor.Clinical neuroradiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Anderson Matheus Pereira da SilvaDepartment of Physiology and pharmacology, Federal University of Pernambuco, Recife, PE, Brazil. Anderson.mhps@icloud.com.
Ocílio Ribeiro GonçalvesDepartment of Medicine, Federal University of Piauí, Teresina, PI, Brazil.
Mariana Lee HanDepartment of Medicine, University of São Paulo, São Paulo, SP, Brazil.
Filipe Virgilio RibeiroDepartment of Medicine, Barão de Mauá University Center, Ribeirão Preto, SP, Brazil.
Luciano FalcãoDepartment of Medicine, Bahiana School of Medicine and Public Health, Salvador, BA, Brazil.
Victor Arthur OhannesianDepartment of Radiology and Diagnostic Imaging, Albert Einstein Israeli Faculty of Health Sciences, São Paulo, SP, Brazil.
Mariana Letícia de Bastos MaximianoDepartment of medicine, Federal Fluminense University, Niterói, RJ, Brazil.
Christian Ken FukunagaDepartment of Medicine, FMABC University Center, São Paulo, SP, Brazil.
Lucca Tamara Alves CarrettaDepartment of Medicine, Santa Casa de Misericórdia de Vitória, Vitória, ES, Brazil.
Ricardo Fonseca Oliveira Suruagy-MottaDepartment of Medicine, Cesmac University Center, Maceio, AL, Brazil.
Christian FerreiraDepartment of Neurosurgery, Northwell, New Hyde Park, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEmergent carotid artery stenting (eCAS) is frequently performed in acute ischemic stroke to restore cerebral perfusion in patients with high-grade carotid stenosis or dissection. In the absence of prior dual antiplatelet therapy (DAPT), these procedures carry a heightened risk of acute in-stent thrombosis. Tirofiban, an intravenous glycoprotein IIb/IIIa inhibitor with rapid onset of action, has been proposed as a bridging antiplatelet strategy, although its efficacy and safety in the neurovascular setting remain uncertain.

objectiveanalysis to evaluate the efficacy and safety of prophylactic tirofiban administration in patients undergoing eCAS without prior DAPT.

methodsA systematic review and meta-analysis were conducted according to PRISMA guidelines. Studies comparing intravenous tirofiban to control (no tirofiban or alternative agents) in patients undergoing eCAS were included. Risk ratios (RR) were calculated using a random-effects model.

resultsFour studies comprising 649 patients were included. Tirofiban use was associated with a lower incidence of acute in-stent thrombosis (RR 0.21; 95% CI 0.09-0.49; I

conclusionTirofiban appears to reduce the risk of acute in-stent thrombosis after eCAS without increasing the incidence of hemorrhagic complications or mortality. Further randomized trials are needed to validate these findings and define optimal periprocedural antiplatelet strategies.

Indexed as

Carotid StenosisPlatelet Aggregation InhibitorsStentsThrombosisTirofibanAdministration, IntravenousHumansPlatelet Aggregation InhibitorsTirofibanAcute ischemic strokeCarotid artery stentingIn-stent thrombosisMeta-analysisTirofiban

Identifiers

PMID40824386

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.