Skip to main content
Journal cover image

The Safety and Efficacy of Continuous Tirofiban as a Monoantiplatelet Therapy in the Management of Ruptured Aneurysms Treated Using Stent-Assisted Coiling or Flow Diversion and Requiring Ventricular Drainage.

Publication ,  Journal Article
Limaye, K; Zanaty, M; Hudson, J; Nakagawa, D; Al Kasab, S; Alvarez, C; Dandapat, S; Kung, DK; Ortega-Gutierrez, S; Jabbour, P; Samaniego, EA; Hasan, D
Published in: Neurosurgery
December 1, 2019

BACKGROUND: Hemorrhagic complications are a major concern for aneurysmal subarachnoid hemorrhage patients treated with stenting or stent-assisted coiling and undergoing additional procedures such as shunting, ventriculostomy placement, and craniotomies/craniectomies. OBJECTIVE: To assess the safety and efficacy of using a continuous infusion of tirofiban as a monoantiplatelet therapy in the management of ruptured aneurysms in the setting of either stent-assisted coiling (SAC) or flow diversion devices (FDD) in patients requiring either an external ventricular drain (EVD) or ventriculoperitoneal shunt (VPS). METHODS: Aneurysmal subarachnoid hemorrhage (aSAH) patients between July 2017 and September 2018 who were treated with SAC or FDD were started on a continuous tirofiban infusion protocol (0.10 μg/kg/min) with no preceding loading dose as a monoantiplatelet therapy. Safety analysis was performed retrospectively to assess the complication rate, hemorrhagic rate, and rate of ischemic events. There were no hemorrhages related to the VPS surgery. RESULTS: Nineteen subjects were included in the series. The patients received a total of 25 procedures that included 19 EVDs and 6 VPSs. Two patients (8.3%) developed small asymptomatic track hemorrhages after EVD placement. One patient developed a large retroperitoneal hemorrhage due to renal artery branch injury during procedure, and another patient developed an idiosyncratic transient thrombocytopenia which resolved after stopping the medication. One patient (4%) developed a transient ischemic attack, which resolved after a bolus of tirofiban. CONCLUSION: Our study suggests that long-term use of intravenous tirofiban monotherapy in aSAH subjects for endovascular SAC or FDD is safe in the perioperative setting.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

December 1, 2019

Volume

85

Issue

6

Start / End Page

E1037 / E1042

Location

United States

Related Subject Headings

  • Ventriculoperitoneal Shunt
  • Tirofiban
  • Subarachnoid Hemorrhage
  • Stents
  • Retrospective Studies
  • Platelet Aggregation Inhibitors
  • Neurology & Neurosurgery
  • Humans
  • Drainage
  • Aneurysm, Ruptured
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Limaye, K., Zanaty, M., Hudson, J., Nakagawa, D., Al Kasab, S., Alvarez, C., … Hasan, D. (2019). The Safety and Efficacy of Continuous Tirofiban as a Monoantiplatelet Therapy in the Management of Ruptured Aneurysms Treated Using Stent-Assisted Coiling or Flow Diversion and Requiring Ventricular Drainage. Neurosurgery, 85(6), E1037–E1042. https://doi.org/10.1093/neuros/nyz226
Limaye, Kaustubh, Mario Zanaty, Joseph Hudson, Daichi Nakagawa, Sami Al Kasab, Carlos Alvarez, Sudeepta Dandapat, et al. “The Safety and Efficacy of Continuous Tirofiban as a Monoantiplatelet Therapy in the Management of Ruptured Aneurysms Treated Using Stent-Assisted Coiling or Flow Diversion and Requiring Ventricular Drainage.Neurosurgery 85, no. 6 (December 1, 2019): E1037–42. https://doi.org/10.1093/neuros/nyz226.
Limaye K, Zanaty M, Hudson J, Nakagawa D, Al Kasab S, Alvarez C, Dandapat S, Kung DK, Ortega-Gutierrez S, Jabbour P, Samaniego EA, Hasan D. The Safety and Efficacy of Continuous Tirofiban as a Monoantiplatelet Therapy in the Management of Ruptured Aneurysms Treated Using Stent-Assisted Coiling or Flow Diversion and Requiring Ventricular Drainage. Neurosurgery. 2019 Dec 1;85(6):E1037–E1042.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

December 1, 2019

Volume

85

Issue

6

Start / End Page

E1037 / E1042

Location

United States

Related Subject Headings

  • Ventriculoperitoneal Shunt
  • Tirofiban
  • Subarachnoid Hemorrhage
  • Stents
  • Retrospective Studies
  • Platelet Aggregation Inhibitors
  • Neurology & Neurosurgery
  • Humans
  • Drainage
  • Aneurysm, Ruptured