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Timing of Thrombosis in Embolization of Unruptured Intracranial Aneurysms: Tirofiban as Rescue Treatment

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Abstract
Purpose: Thrombosis is one of the main complications of endovascular treatment for unruptured intracranial aneurysms (UIA). This article reports the timing and initial location of thrombosis and prognosis after the use of tirofiban for performing coil embolization for UIA. Methods: This study retrospectively collected 1686 cases of intracranial aneurysms treated with coil embolization from January 2013 to February 2018. Ruptured cases were excluded. The presumed causes and timing of thrombosis, the response after tirofiban administration and the modified Rankin scale (mRS) score at 3?months were reviewed. Results: Of the 26?patients 76% were female and middle cerebral artery and basilar artery aneurysms accounted for 7?cases. The initial location of thrombosis was related to the stent (n?= 14, 53.8%) or coil (n?= 12, 46.2%). Of the patients 19 (73.1%) developed thrombosis during the procedure, and 5 patients (19.2%) developed it within 1 day of the procedure. Median duration between the thrombotic procedure and initial thrombosis was 38.5?min, 12 patients were symptomatic but more than half completely recovered after using tirofiban. Good clinical outcome (mRS 0?2) was seen in 92.3%. In the subgroup analysis, median time from the first thrombotic procedure to initial thrombosis within 1 day was 38.0?min (stent-related group) and 35.0?min (coil-related group, p?= 0.651). Conclusion: In most cases of embolization for UIA, thrombosis requiring the use of tirofiban occurs intraprocedurally or on the first day after the procedure. Careful observation of thrombosis during the procedure is important and tirofiban should be used for a?better outcome even if the infarction progresses.
Author(s)
이동환이덕희박중철신재호송윤선정재우신재전서대철
Issued Date
2021
Type
Article
Keyword
ThrombosisIntracranial aneurysmCoil embolizationTirofibanGlycoprotein IIb/IIIa inhibitor
DOI
10.1007/s00062-019-00873-2
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7631
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_proquest_miscellaneous_2344230092&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Timing%20of%20Thrombosis%20in%20Embolization%20of%20Unruptured%20Intracranial%20Aneurysms:%20Tirofiban%20as%20Rescue%20Treatment&offset=0&pcAvailability=true
Publisher
Clinical Neuroradiology
Location
독일
Language
영어
ISSN
1869-1439
Citation Volume
31
Citation Number
1
Citation Start Page
125
Citation End Page
133
Appears in Collections:
Medicine > Medicine
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