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Background: Thromboembolic complications after stenting of intracranial aneurysms may be affected by antiplatelet administration. Aims: This retrospective study aimed to assess the safety of intravenous tirofiban versus loading dose of oral clopidogrel for preventing thromboembolism in stent-assisted coiling of intracranial aneurysms. Methods: From January 2006 to December 2013, 281 patients with cerebral aneurysms were treated with stent-coiling using two antiplatelet strategies in comparison: the initial strategy (a loading dose of ≥300 mg clopidogrel followed by dual antiplatelet, clopidogrel group) and the modified strategy (intravenous administration of tirofiban 8 μg/kg over 3 min followed by a maintenance dose of 0.1 μg/kg/min for 24 h, tirofiban group). The end points were rates of perioperative thromboembolic events and intracranial hemorrhages. Results: Thromboembolic events were observed more often in the clopidogrel group (13/120 aneurysms, 10.83%) than the tirofiban group (6/178 aneurysms, 3.37%; P=0.010), with no increase in the rate of intracranial hemorrhages (P=0.164). In the ruptured subgroups, thromboembolic events were significantly fewer in the tirofiban subgroup (5/128, 3.91%) compared with the clopidogrel subgroup (7/53, 13.21%; P=0.043) with no increase in the rate of hemorrhage (P=0.360). Conclusions: Intravenous administration of tirofiban is safe in intracranial aneurysms treated with stent-assisted coiling. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety and efficiency of mechanical thrombectomy with Solitaire AB stent in the treatment of acute ischemic stroke caused by large artery occlusion of anterior circulation. Methods Clinical data of 31 patients with acute ischemic stroke caused by large artery occlusion of anterior circulation, who underwent mechanical thrombectomy with Solitaire AB stent, were reviewed retrospectively. Recanalization results were assessed by immediate scale of thrombolysis in cerebral infarction (TICI) after thrombectomy. National Institutes of Health Stroke Scale (NIHSS) was used to evaluate neurological function at one week after operation, and modified Rankin Scale (mRS) was used to evaluate outcomes at 3 months after operation. Complications related to the procedure, such as perioperative embolic events, intracranial hemorrhage or death within 3 months after operation, were recorded. Results A total of 33 Solitaire AB stents were used in 31 patients. The initial success rate of recanalization was 61.29% (19/31). Among the other 12 patients, one patient with TICI Grade 2a and favorable distal blood supply was not further freated, while 11 patients underwent stent implantation as a rescue treatment and 9 of them were successful. The final recanalization rate was 90.32% (28/31). The NIHSS score one week after operation was 8.81 ± 3.40, which was significantly lower than the score 16.06 ± 4.82 on admission (t = -7.104, P = 0.000). Three months after operation, there were 16 patients (51.61%) with good prognosis (mRS score ≤ 2). Perioperative embolization occurred in 3 patients. Intracranial hemorrhage occurred in 4 patients during the 3-month follow-up period, and 6 patients were dead. Conclusions The application of Solitaire AB stent in mechanical thrombectomy for treating acute ischemic stroke is efficient and safe. Stent implantation can be used as adjunctive treatment when initial recanalization with Solitaire AB stent is failed. [ABSTRACT FROM AUTHOR]