Clinical efficacy of tirofiban in the endovascular therapy of patients with acute ischaemic stroke due to intracranial atherosclerotic disease: A meta-analysis

• Published in: Clinical neurology and neurosurgery 2024-12, Vol.247, p.108599, Article 108599
• Main Authors: Wang, Kangmeng, Huang, Kailai, Xia, Min, Li, Qi, Li, Huajian, Zhang, Manyu, Feng, Xiaoli, Wang, Tan, Zhao, Zhenqiang, Qiu, Zhongming, Li, Wei
• Format: Article
• Language: English
• Subjects: Acute ischemic stroke; Angioplasty; Arteriosclerosis; Atherosclerosis; Bias; Cardiovascular system; Citation management software; Cohort analysis; Collaboration; Endovascular Procedures - methods; Endovascular therapy; Fibrinolytic Agents - administration & dosage; Fibrinolytic Agents - therapeutic use; Hemorrhage; Humans; Intra-arterial; Intracranial Arteriosclerosis - complications; Intracranial Arteriosclerosis - drug therapy; Intracranial atherosclerotic disease; Ischemia; Ischemic Stroke - drug therapy; Ischemic Stroke - etiology; Meta-analysis; Mortality; Patients; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - therapeutic use; Risk assessment; Stroke; Tirofiban; Tirofiban - administration & dosage; Tirofiban - therapeutic use; Treatment Outcome
• ISSN: 0303-8467; 1872-6968; 1872-6968
• DOI: 10.1016/j.clineuro.2024.108599

The treatment results of combination of arterial injection of tirofiban with endovascular therapy (EVT) for acute large vessel occlusion (LVO) stroke due to intracranial atherosclerotic disease (ICAD) were inconsistent. This meta-analysis aims to assess the safety and efficacy of ICAD-LVO treatment by intra-arterial injection of tirofiban combined with EVT. Relevant studies were identified through a systematic literature search in Pubmed, EMBASE, Web of Science and Cochrane Library databases, covering articles published from January 2010 to July 2024. The efficacy outcomes assessed in the meta-analysis included favorable functional outcome and recanalization rates. Safety outcomes included mortality and symptomatic intracranial haemorrhage (sICH). The meta-analysis consisted of data from 11 studies, which included 1 randomised controlled trial (RCT), 5 prospective cohort studies, and 5 retrospective cohort studies, encompassing a total of 2869 patients. The findings showed that tirofiban+EVT for ICAD-LVO was associated with significant improvements in favorable functional outcomes (RR, 1.12; 95 %CI, 1.04–1.21; P=0.005) and reductions in mortality rates (RR, 0.72; 95 %CI, 0.62–0.83; P