Intra-arterial tirofiban infusion for thromboembolism during endovascular treatment of intracranial aneurysms.

Abstract

Thromboembolism is one of the most common and serious complications associated with the endovascular embolization of intracranial aneurysms. We report our clinical experiences with intra-arterial tirofiban infusion during aneurysm embolization. The clinical, radiological, and laboratory data of 24 patients harboring 25 aneurysms (25 procedures) who underwent intra-arterial tirofiban infusion for thromboembolism during the endovascular treatment of intracranial aneurysms were reviewed retrospectively. Thrombi or emboli were resolved by superselective intra-arterial tirofiban infusion via a microcatheter. The study cohort comprised 14 unruptured and 11 ruptured aneurysms. Intra-arterially infused tirofiban doses ranged from 0.2 to 1.0 mg (mean +/- standard deviation, 0.64 +/- 0.25 mg). Thromboemboli were resolved, and arteries were recanalized on all occasions except one: a case of distal middle cerebral artery embolism. No hemorrhagic complications related to intra-arterial tirofiban infusion occurred. Intra-arterial tirofiban delivery appears to be a safe and effective treatment modality when thromboembolism is encountered during the endovascular treatment of intracranial aneurysms.