Mechanical Solitaire Thrombectomy with Low-Dose Booster Tirofiban Injection

Area of Science:

• Neurology
• Interventional Neuroradiology
• Cardiovascular Medicine

Background:

• Mechanical thrombectomy using Solitaire stent is effective for acute ischemic stroke.
• Optimizing recanalization rates remains a key goal in endovascular stroke treatment.
• Intra-arterial tirofiban has been explored as an adjunct to mechanical thrombectomy.

Purpose of the Study:

• To evaluate the safety and efficacy of mechanical Solitaire thrombectomy with a low-dose intra-arterial tirofiban booster injection.
• To assess the recanalization rates achieved with this modified thrombectomy technique.

Main Methods:

• Thirteen consecutive patients with acute ischemic stroke underwent mechanical Solitaire thrombectomy.
• A low-dose intra-arterial tirofiban injection (250-500 µg) was administered into the occluded segment post-stent deployment.
• Occlusion sites included middle cerebral artery, internal carotid artery, and basilar artery.

Main Results:

• 100% successful recanalization (TICI 3 in 8 patients, TICI 2b in 5 patients) was achieved after a maximum of 3 attempts.
• Favorable clinical outcome (modified Rankin Scale ≤ 2) was observed in 61.5% of patients.
• Procedural complications included subarachnoid hemorrhage (n=2) and hemorrhagic transformation (n=1); one mortality occurred due to reperfusion swelling.

Conclusions:

• Mechanical Solitaire thrombectomy combined with low-dose intra-arterial tirofiban injection is a safe and effective method for achieving high recanalization rates in acute ischemic stroke.
• This modified approach may enhance recanalization without increasing hemorrhagic complications.
• Further research is warranted to confirm these findings in larger cohorts.