Mechanical thrombectomy combined with tirofiban for treatment of acute intracranial atherosclerotic cerebral infarction: clinical observations and effect on serum inflammatory factors.

OBJECTIVE

To evaluate the clinical efficacy of mechanical thrombectomy (MT) combined with tirofiban in treating acute intracranial large artery atheromatous cerebral infarction and its effect on inflammatory factor levels.

METHODS

This retrospective study included 102 patients with acute intracranial large atherosclerotic cerebral infarction admitted to Jili Hospital, Liuyang City, Hunan Province, between December 2022 and December 2024. Patients were divided into a control group (MT) and an observation group (MT + tirofiban). Pre-treatment and post-treatment assessments included revascularization rate, hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), D-dimer (D-D), prothrombin time (PT), activated partial thromboplastin time (APTT), neuron-specific enolase (NSE), central neural specific protein (S100β), and myelin basic protein (MBP). Neurological function was evaluated using the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), modified Barthel index (MBI), and Fugl-Meyer assessment (FMA). Logistic analysis was used to identify factors influencing vascular re-canalization.

RESULTS

After treatment, the revascularization rate was higher in the observation group (94.12% vs. 78.43%, P<0.05). NIHSS, D-D, hs-CRP, TNF-α, IL-6, NSE, S100β, and MBP levels decreased significantly, with lower values observed in the observation group (P<0.05). MMSE, MBI, and FMA scores increased more in the observation group (P<0.05). PT and APTT were prolonged significantly, with higher values in the observation group (P<0.05). Logistic regression identified post-treatment NIHSS score as an independent risk factor for re-occlusion (P<0.05).

CONCLUSION

Tirofiban combined with MT improves revascularization in patients, reduces inflammation and neurobiochemical damage, enhances neurological function, and lowers the risk of re-occlusion in patients with acute intracranial large artery atheromatous cerebral infarction.