Application of tirofiban in the perioperative period of patients with emergency neurovascular surgery

Objective To investigate the effect of tirofiban in the perioperative period of patients with emergency neurovascular intervention. Methods From January 2016 to June 2018, a total of 94 acute ischemic stroke(AIS)patients with stent placement in the Department of Neurology of Second Affiliated Hospital of Xi'an Jiaotong University were selected, and they were divided into routine treatment group and tirofiban group according to the preoperative anti-platelet therapy. Patients in the routine treatment group were given adequate dual anti-platelet therapy before operation, while patients in the tirofiban group were treated with dual anti-platelet therapy less than 3 days before operation, loading doses of aspirin enteric coated tablets and clopidogrel bisulfate tablets during the operation and tirofiban hydrochloride at the same time. The scores of National Institutes of Health Stroke Scale(NIHSS)and blood platelet count before operation and 3 days after operation, bleeding events(such as intracranial hemorrhage, systemic hemorrhage)and the score of modified Rankin Scale(mRS)after 3 months were compared between two groups. Results Three days after treatment, the NIHSS score in both groups significantly reduced, and the NIHSS score in the tirofiban group was significantly lower than that in the routine treatment group(P<0.05). Compared with that before operation, the blood platelet count in both groups was significantly higher at 3 days after operation - (P<0.05), but there was no significant difference between the two groups after operation(P>0.05). There was no intracranial hemorrhage in both groups, and there was no significant difference in bleeding events between the two groups(P>0.05). The clinical neurological function of the two groups improved significantly at 3 months after operation, and the improvement effect of the tirofiban group was significantly better than that of the routine treatment group(P<0.05). Conclusion Application of tirofiban shows a significant therapeutic effect in the perioperative period of patients with emergency neurovascular intervention, which can reduce the long-term recurrence rate and mortality, improve the status of neurological deficit, and it has higher safety.