TITACIPPI (Tirofiban with Intravenous Thrombolysis in Acute Anterior Choroidal Infarction \[ACI\] and Paramedian Pontine Infarction \[IPP\]) study aimed to evaluate the efficacy and safety of simultaneous infusion of tirofiban with intravenous thrombolysis (IVT + tirofiban group) compared to IVT alone (IVT alone group) in patients with ACI or PPI. TITACIPPI study is a retrospective, single-center observational study conducted from March 01, 2014, to December 31, 2022.
ACI and PPI are frequently associated with clinical fluctuations, characterized by recurrent transient more or less regressive stereotyped episodes of focal motor deficits affecting the face, arm, and leg, and finally with a risk of lasting neurological worsening that can lead to definite residual neurological disability. These ischemic strokes (ACI and PPI) are not very sensitive to IVT, thus 26% to 48% will experience neurological aggravation despite the administration of this treatment. Studies in Asia have shown a possible clinical benefit of simultaneous infusion of tirofiban with IVT in patients with ischemic stroke of atheromatous or microatheromatous origin without additional bleeding risk. To date, no studies have tested the efficacy of simultaneous infusion of tirofiban and IVT in the well-defined subgroup of ACI and PPI and a non-Asian population.
Study Type
OBSERVATIONAL
Enrollment
48
Patients received intravenous tenecteplase 0.25mg/kg (maximum dose: 25mg), administered as a bolus over 5 to 10 seconds or intravenous alteplase 0.9 mg/kg (maximum dose: 90mg), 10% as bolus and the remainder as continuous perfusion over 1 hour.
IVT with tenecteplase or alteplase with continuous infusion of tirofiban 0.4µg/kg/min continued for 24 to 48 hours.
Centre Hospitalier Sud Francilien
Corbeil-Essonnes, France
Volume of the ischemic lesion
Evolution of the volume of the ischemic lesion in diffusion-weighted imaging between initial MRI and post-therapy MRI
Time frame: at 24 hours
NIHSS
NIHSS (from 0=favorable to 42=unfavorable)
Time frame: at day 7
Modified Rankin Scale (mRS)
Proportion of the patients with mRS 0-2
Time frame: at 3 months
Secondary neurological deterioration
Rate of secondary neurological deterioration (fluctuations or neurological progression defined as an increase of at least 1 point in NIHSS).
Time frame: at 72 hours
Cerebral hemorrhages
Rates of cerebral hemorrhages defined according to the Heidelberg Bleeding Classification
Time frame: at 24 hours
Systemic bleedings
Rate of significant systemic bleeding (i.e., requiring specific treatment).
Time frame: at 24 hours
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