Acute Profound Thrombocytopenia Within 1 Hour After Small Doses of Tirofiban

Ye, Ran; Xu, Hua; Huo, Yunyun; Tian, Chenglin; Yu, Shengyuan

doi:10.1097/mjt.0000000000001553

Cited by 3 publications

(1 citation statement)

References 6 publications

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“…Thrombocytopenia during the administration was infrequent in this trial and was rapidly reversible without sequelae after the cessation of the infusion [ 24 ]. Severe thrombocytopenia with so-called vanishing platelets by using tirofiban is a rare complication [ 25 ]. In our study, we observed acute and severe thrombocytopenia in 2 patients (2/62, 3.2%).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety Outcomes for Acute Ischemic Stroke Patients Treated with Intravenous Infusion of Tirofiban After Emergent Carotid Artery Stenting

Garayzade,

Berlis,

Schiele

et al. 2023

Clin Neuroradiol

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Introduction Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage. Aim of the Study Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients. Methods Primary endpoint: symptomatic hemorrhage. Secondary endpoints: 90-day functional outcome and mortality. Results Of the 62 patients, 21 (34%) received tirofiban as a single antiplatelet, and 41 (66%) received combined therapy. Premedication with anticoagulants and antiplatelets was significantly more frequent in the tirofiban-only group. The rate of symptomatic haemorrhage was significantly lower in the tirofiban-only group than in the combined group (4.8% vs. 27%, p = 0.046). The patients with tirofiban alone had a significantly better functional outcome at day 90 than the combined group (52% vs. 24%, p = 0.028). Mortality was equal (24%) in both groups. Pre-interventional NIHSS score (p = 0.003), significant blood pressure fluctuations (p = 0.012), tandem occlusion (p = 0.023), and thrombolysis (p = 0.044) showed relevant influence on the rate of symptomatic hemorrhage in the entire patient cohort. Conclusions A single antiplatelet therapy with tirofiban regardless of the premedication may improve the functional outcome in patients with stroke due to acute extracranial carotid lesion and emergent carotid stenting with lower rates of serious intracranial haemorrhage. For patients with high pre-interventional NIHSS score, tandem occlusion and after pre-interventional thrombolysis, caution is advised. Additionally, strict blood pressure monitoring should be conducted during the first 72 h after intervention.

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Section: Discussionmentioning

confidence: 99%