Glycoprotein IIb/IIIa inhibitors for the neurointerventionalist

Abstract

Antiplatelet therapies are commonly used in neurointerventional procedures. However, specific guidelines for their use in these settings is lacking and it can often be difficult to balance the potential risks and benefits of these medications. Considering the continued growth and adoption of neurointerventional procedures, it is crucial to understand the properties of these agents in order to use them safely. Large-scale clinical trials are still needed to clarify many of these aspects for this emerging field. However, the existing literature already provides insight into which antiplatelet drugs are of benefit to the neurointerventionalist as well as their associated risks of ischemic and hemorrhagic complications. Hence, this review focuses on the applications of GPIIb/IIIA inhibitors to neurointerventional procedures.

Comparison of Safety and Efficacy after Emergency Stenting in Patients Exhibiting Intracranial Atherosclerotic Stenosis Associated with Large-vessel Occlusion with and without Intravenous Infusion of Tirofiban

“…The rate of failure of MT in the treatment of acute ischaemic stroke ranges between 10 and 30% with a strong negative effect on the clinical outcome of these patients [25]. Intracranial stenosis related to atherosclerotic disease seems to be a major reason for failed MT, but some patients seem to benefit from intracranial rescue stenting in these cases [15,[19][20][21]. However, a major problem remains the adequate antiplatelet regimen for these patients.…”

“…However, there is no consensus on the periprocedural use of prophylactic antiplatelet agents during stent angioplasty in acute stroke, and the use of antiplatelet agents varies considerably [15][16][17]. The classical oral antiplatelet agents cannot be reversed easily and have a half-life of several days.…”

“…Tirofiban is a highly selective, fast-acting glycoprotein IIb/IIIa (Gp IIb/IIIa) platelet receptor antagonist with a short half-life that can be given intravenously. Its administration in the systemic treatment of acute ischaemic stroke appears to be safe [15,[19][20][21], but data in this regard are sparse and inhomogeneous. Therefore, the aim of our study was to report our experience with the use of tirofiban as first-line antiplatelet therapy after rescue stenting for LVO due to atherosclerotic stenosis.…”

Revolutionizing Neurocare: Biomimetic Nanodelivery Via Cell Membranes

“…In various physiopathological contexts-ranging from vascular endothelial damage and shear stress to glycoprotein IIb/IIIa activation-platelets undergo activation, leading to pseudopod formation, cytoplasmic degranulation, and the release of bioactive proteins and cytokines. [226][227][228] These events are critical for immune regulation, brain tumor progression, and the hemostasis-coagulation cascade. Activated platelets also act as secondary agonists in platelet aggregation and fibrin formation, essential for blood clot development.…”