Safety and efficacy of tirofiban before stenting for symptomatic intracranial atherosclerotic stenosis

A recent study has shown that adjuvant intravenous tirofiban before stenting may lead to a decreased likelihood of acute stent thrombosis (AST) during stent angioplasty in patients experiencing symptomatic high-grade intracranial atherosclerotic stenosis (ICAS). This study’s findings were published in the journal, Neurology.

In this prospective, multicenter, randomized clinical trial, patients with symptomatic high-grade ICAS scheduled for stent angioplasty were randomly assigned to either receive intravenous tirofiban before stenting or not, in a 1:1 ratio. The study included 100 participants in the tirofiban group and 100 participants in the control group. Primary outcomes measured were the incidence of AST within 30 minutes post-stenting, periprocedural new-onset ischemic stroke, and symptomatic intracranial hemorrhage.

At the end of the study, there was a lower incidence of AST in the tirofiban group when compared to the control group (4.0% vs 14.0%).

The above study demonstrated that the use of adjuvant intravenous tirofiban prior to stenting could potentially reduce the occurrence of AST in patients with symptomatic high-grade ICAS undergoing stent angioplasty.