Efficacy and safety of intra-arterial tirofiban in acute ischemic stroke without large-vessel occlusion.

OBJECTIVES: Intra-arterial tirofiban has emerged as a potential alternative for those patients with acute ischemic stroke (AIS). This study evaluated the effectiveness and safety of intra-arterial tirofiban in AIS patients without large- or medium-vessel occlusions. MATERIAL AND METHODS: Sixty patients with AIS who were within 24 hours of symptom onset and did not have significant blockages in large or medium blood vessels were assigned to treatment and control groups via a non-randomized, patient-preference allocation protocol: the control group (n = 30) received intravenous tirofiban and dual antiplatelet therapy, and the treatment group (n = 30) received intra-arterial tirofiban via catheterization, followed by the same medication regimen. The neurological function, functional outcomes, and safety evaluations were measured at 90 days. RESULTS: Both groups experienced a substantial decrease in NIHSS scores post-treatment (p < 0.05). The treatment group had significantly lower NIHSS scores at 24 hours, 72 hours, and 14 days compared to the control group (p < 0.05). The treatment group had a treatment efficacy rate of 91.1% at 14 days, while the control group had a rate of 80.0% (p < 0.05). At 90 days, both groups showed significant improvements in mRS and BI scores (p < 0.05), with the treatment group having a lower median mRS score and a higher median BI score compared to the control group (p < 0.05). There were no statistically significant differences in the incidence of adverse events between the two groups (p > 0.05). CONCLUSION: Intra-arterial tirofiban administration benefits AIS patients without large- or medium-vessel occlusions, improving neurological function, reducing disability, and enhancing functional independence.