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Rescue treatment with intra-arterial tirofiban infusion and emergent carotid stenting

Authors
 Tae Jin Song  ;  Kee Oog Lee  ;  Dong Joon Kim  ;  Kyung-Yul Lee 
Citation
 YONSEI MEDICAL JOURNAL, Vol.49(5) : 857-859, 2008 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2008
MeSH
Carotid Artery, Internal* ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/drug therapy* ; Carotid Stenosis/surgery ; Emergency Treatment ; Humans ; Infusions, Intra-Arterial ; Male ; Middle Aged ; Radiography ; Stents ; Tirofiban ; Tyrosine/administration & dosage ; Tyrosine/analogs & derivatives* ; Tyrosine/therapeutic use
Keywords
Carotid stent ; glycoprotein Iib/IIIa receptor blocker ; tissue plasminogen activator
Abstract
Rapid arterial rethrombosis is associated with high-grade residual stenosis and usually occurs at the site of the initial occlusion, resulting in reocclusion of the recanalized artery. Platelets may play an active role in such rethrombosis after thrombolytic-induced clot lysis. Given that glycoprotein IIb/IIIa receptor blockers, like tirofiban, prevent thrombus formation by inhibiting the final common pathway of platelet aggregation, they may be helpful for treating rethrombosis after thrombolysis. A 64-year-old man presented with an acute ischemic stroke due to internal carotid artery (ICA) occlusion. The ICA was recanalized by intravenous thrombolysis but reoccluded shortly after recanalization. The reoccluded ICA was successfully recanalized using intra-arterial tirofiban. A carotid stent was subsequently inserted to relieve severe stenosis and to prevent recurrent stroke. Here, we report a case of rescue treatment of a successfully recanalized ICA by intra- arterial tirofiban. We suggest that rescue use of intra-arterial tirofiban may be effective and safe, especially in hemorrhage prone situations, due to the relatively lower dose of tirofiban compared with intravenous doses.
Files in This Item:
T200801256.pdf Download
DOI
10.3349/ymj.2008.49.5.857
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Lee, Kyung Yul(이경열) ORCID logo https://orcid.org/0000-0001-5585-7739
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107542
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