Effect of intraductal administration of low-dose Tirofiban followed by sequential intravenous infusion on postoperative outcomes in patients with tandem acute ischemic stroke with large vessel occlusion undergoing combined thrombectomy
HAN Yuhui
LI Qingjin
JIANG Hua
HONG Chunyong
CHEN Yi
WANG Yilong
Abstract：Objective To explore the effect of intraductal administration of low-dose Tirofiban followed by sequential intravenous infusion on the postoperative outcomes of patients with tandem acute ischemic stroke with large vessel occlusion(AIS-LVO)undergoing combined thrombectomy.Methods A total of 116 patients with tandem AIS-LVO admitted from May 2021 to May 2023 were selected and divided into the control group(n=58)and the observation group(n=58)according to different treatment methods.The control group was treated with combined thrombectomy,and the observation group was given combined sequential therapy with low-dose Tirofiban on the basis of the control group.The vascular recanalization rate,platelet aggregation rate,neurological deficit-related indicators[homocysteine(Hcy),vascular endothelial growth factor(VEGF),fibroblast growth factor 4(FGF4)],and oxidative stress indicators[recombinant human Parkinson's protein 7(PARK7),stress-inducible protein Sestrin2(SESN2),hypoxia-inducible factor-1α(HIF-1α)],National Institutes of Health Stroke Scale(NIHSS)score,Modified Rankin Scale(mRS)score]were compared between the two groups.Results The vascular recanalization rate in the observation group was 96.55%(56/58),which was higher than that in the control group[86.21%(51/58)](P<0.05).At two weeks after the operation,the platelet aggregation rate and NIHSS score of the observation group were both lower than those of the control group(P<0.05).At two weeks after the operation,the levels of serum Hcy,VEGF,FGF4,PARK7,HIF-1α and SESN2 in the observation group were all lower than those in the control group(P<0.05).At three months after the operation,the proportion of the observation group with an mRS Score of 0-2 was higher,while the proportion with an mRS Score of>2 was lower than that of the control grou(P<0.05).Conclusion Intraductal administration of low-dose Tirofiban followed by sequential intravenous infusion is beneficial for improving the neurological function of patients with tandem AIS-LVO undergoing combined thrombectomy,alleviating oxidative stress,inhibiting platelet aggregation,increasing the vascular recanalization rate,thereby promoting a favorable outcome after combined thrombectomy.
Keywords：tandem acute ischemic stroke with large vessel occlusioncombined thrombectomyTirofibanneurological functionplatelet aggregationoxidative stressmodified Rankin scale
Publication Date：2025-10-13
Online Publishing Date：2025-10-21(First online date of this platform, not the publication date of the document)
Pages：7( 115-121 )