Document Detail


Intra-arterial tirofiban infusion for partial recanalization with stagnant flow in hyperacute cerebral ischemic stroke.
MedLine Citation:
PMID:  22192548     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early reocclusion is a major concern associated with poor clinical outcomes in patients with an ischemic cerebral stroke. This occurs most frequently in patients with partial initial recanalization. This study focuses on partial recanalization with stagnant antegrade flow after intravenous (IV) tPA or spontaneously, treated with the administration of intra-arterial (IA) tirofiban. Three patients with initial M1 occlusion on diagnostic studies had an occluded segment that was recanalized with stagnant flow after IV tPA or spontaneously. In all cases, IA tirofiban was administrated. We evaluated the distal blood flow and the degree of vascular narrowing in the pre and post-procedure angiography and at follow-up in addition to the clinical status. In all patients, severe vascular narrowing with stagnation of blood flow was detected in the initial M1. After infusion of IA tirofiban, improvement of the distal blood flow was achieved rapidly within 40 minutes in all patients. The severe vascular narrowing resolved rapidly in two patients without residual stenosis. In one patient, moderate vascular narrowing was still present. The median baseline National Institutes of Health Stroke Scale (NIHSS) scores were 18 and the median post-procedural NIHSS scores were 2 at two weeks. No intracerebral hemorrhage occurred in any of the patients. Treatment with IA tirofiban was safe and effective in patients with partial initial recanalization. It can be suggested that detection of any partial recanalization is time for administration of glycoprotein IIb-IIIa receptor inhibitor in hyperacute ischemic stroke.
Authors:
Seung Kug Baik; S J Oh; K-P Park; J-H Lee
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-12-16
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  17     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-23     Completed Date:  2012-03-01     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  442-51     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, Pusan National University Yangsan Hospital, Medical Research Institute, Pusan National University School of Medicine, Yangsan, Korea. skbaik9@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Blood Flow Velocity
Brain Ischemia / drug therapy*,  radiography
Cerebral Angiography
Diffusion Magnetic Resonance Imaging
Female
Fibrinolytic Agents / administration & dosage*
Humans
Infusions, Intra-Arterial
Male
Middle Aged
Retrospective Studies
Stroke / drug therapy*,  radiography
Treatment Outcome
Tyrosine / administration & dosage,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 144494-65-5/tirofiban; 55520-40-6/Tyrosine
Comments/Corrections

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