International Stroke Conference 2025  /  Neuroendovascular Oral Abstracts I  /  Intravenous Tirofiban as An Adjunct to Endovascular Therapy for Posterior Circulation Strokes with Tandem Lesions: One-Year Outcomes
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American Heart Association

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Final ID: 13

Intravenous Tirofiban as An Adjunct to Endovascular Therapy for Posterior Circulation Strokes with Tandem Lesions: One-Year Outcomes

Abstract Body: Background: The effectiveness and safety of intravenous Tirofiban as an adjunct to endovascular therapy (EVT) in posterior circulation patients with tandem lesions (PCTL) remain uncertain.
Methods: This study utilized individual patient data pooled from two multicenter observational studies: the BASILAR and the PERSIST registries. We included patients with acute ischemic stroke due to PCTLs who were treated with EVT. The patients were divided into two groups based on whether they received adjunctive intravenous Tirofiban therapy or not. The primary efficacy outcome was favorable functional outcome, defined as modified Rankin Scale (mRS) scores of 0-3 at one year. Secondary outcomes included safety assessments, such as rates of symptomatic intracerebral hemorrhage (sICH), early neurological deterioration (defined as a decline in National Institutes of Health Stroke Scale [NIHSS] score by ≥4 points within 72h), and all-cause mortality at one year. We also evaluated procedural outcomes, including successful reperfusion, defined as modified Thrombolysis in Cerebral Infarction (mTICI) grade 2b-3, and complete reperfusion, defined as mTICI 3.
Results: Among 210 patients treated with EVT (126 Tirofiban, 84 Non-Tirofiban), successful reperfusion (mTICI 2b-3) was achieved in 109 (86.5%) Tirofiban patients versus 64 (76.2%) non-Tirofiban patients (Adjusted OR 1.75, 95%CI [0.76-4.03], P=0.19). Complete reperfusion (mTICI 3) was achieved in 74 (58.7%) Tirofiban patients versus 36 (42.9%) non-Tirofiban patients (Adjusted OR 2.08, 95%CI [1.04-4.14], P=0.04). Rates of sICH were 6 (4.8%) in the Tirofiban group versus 9 (10.7%) in the non-Tirofiban group (Adjusted OR 0.24, 95%CI [0.04-1.36], P=0.11). Early neurological deterioration occurred in 18 (14.3%) Tirofiban patients versus 32 (38.1%) non-Tirofiban patients (Adjusted OR 0.20, 95%CI [0.09-0.46], P<0.001). One-year mRS 0-3 was achieved in 48/119 (40.3%) Tirofiban patients versus 24/82 (29.3%) non-Tirofiban patients (Adjusted OR 5.38, 95%CI [2.21-13.06], P<0.001). One-year mortality was 45/119 (37.8%) in the Tirofiban group versus 43/82 (52.4%) in the non-Tirofiban group (Adjusted OR 0.26, 95%CI [0.12-0.59], P=0.001).
Conclusion: Intravenous Tirofiban as an adjunct to EVT may improve long-term functional outcomes in acute ischemic stroke patients due to PCTLs without significantly increasing the risk of hemorrhagic complications. Further prospective studies are warranted to validate these findings.
  • Doheim, Mohamed  ( UPMC Stroke Institute , Pittsburgh , Pennsylvania , United States )
  • Sun, Wen  ( The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China , Hefei , China )
  • Nogueira, Raul  ( University of Pittsburgh , Pittsburgh , Pennsylvania , United States )
  • Li, Wei  ( First Affiliated Hospital, Hainan M , Haikou , China )
  • Zi, Wenjie  ( Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University , Xinqiao , China )
  • Qiu, Zhongming  ( The 903th Hospital of The People’s Liberation Army , Hangzhou , China )
  • Han, Zhongkui  ( Fuyang People's Hospital , Fuyang , China )
  • Chen, Zhonglun  ( Mianyang central Hospital , Mianyang , China )
  • Zhao, Zhenqiang  ( First Affiliated Hospital, Hainan Medical University , Hainan , China )
  • Chen, Zhibin  ( First Affiliated Hospital, Hainan M , Haikou , China )
  • Al-bayati, Alhamza  ( UPMC Stroke Institute , Pittsburgh , Pennsylvania , United States )
    • Author Disclosures:
    Mohamed Doheim: DO NOT have relevant financial relationships | Wen Sun: No Answer | Raul Nogueira: DO have relevant financial relationships ; Consultant:Stryker:Active (exists now) ; Consultant:Phenox:Active (exists now) ; Individual Stocks/Stock Options:Vesalio:Active (exists now) ; Individual Stocks/Stock Options:Rapid Pulse:Active (exists now) ; Individual Stocks/Stock Options:Euphrates :Active (exists now) ; Individual Stocks/Stock Options:Brainomix:Active (exists now) ; Individual Stocks/Stock Options:Viz.AI:Active (exists now) ; Consultant:Perfuze:Active (exists now) ; Consultant:Route 92:Active (exists now) ; Consultant:Imperative Care:Active (exists now) ; Consultant:Microvention:Active (exists now) ; Consultant:Medtronic :Active (exists now) ; Consultant:Cerenovus:Active (exists now) | Wei Li: DO NOT have relevant financial relationships | Wenjie Zi: DO NOT have relevant financial relationships | Zhongming Qiu: DO NOT have relevant financial relationships | Zhongkui Han: No Answer | Zhonglun Chen: No Answer | Zhenqiang Zhao: No Answer | Zhibin Chen: No Answer | Alhamza Al-Bayati: DO NOT have relevant financial relationships
Meeting Info:

International Stroke Conference 2025

2025

Los Angeles, CA

Session Info:

Neuroendovascular Oral Abstracts I

Wednesday, 02/05/2025 , 07:30AM - 09:00AM

Oral Abstract Session

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