World neurosurgery · 2019
Safety and Feasibility of Using Argatroban Immediately After Mechanical Thrombectomy for Large Artery Occlusion.
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Kim Jeeyong, Yi Ho Jun, Lee Dong Hoon, Sung Jae Hoon
Аннотация
BACKGROUND: This study aims to evaluate the safety and effects of using argatroban, immediately after mechanical thrombectomy (MT) with large artery occlusion.
METHODS: A total of 302 patients were divided into 2 groups: the MT with post argatroban (MT+ARG) group and the MT without post argatroban (MT-ARG) group. Baseline characteristics, time interval categories, and results of MT were reviewed. Outcome assessment with the National Institutes of Health Stroke Scale, modified Rankin Scale, TICI, reocclusion, and various complications were evaluated and compared between the 2 groups. Subgroup analysis was also performed for patients using tissue plasminogen activator or tirofiban.
RESULTS: Baseline characteristics and time intervals were similar for the 2 groups. The MT+ARG group showed significantly less occurrence of reocclusion at 24 hours and 7 days compared with the MT-ARG group (2.5% vs. 6.0%, P = 0.018; 4.2% vs. 8.2%, P = 0.020). However, there were no significant differences in incidence of complications such as brain hemorrhage between the 2 groups. In subgroup analysis with tissue plasminogen activator, the MT+ARG group showed less occurrence of reocclusion at 24 hours and 7 days compared with the MT-ARG group (P = 0.008 and P = 0.018, respectively). In subgroup analysis with tirofiban, reocclusion at 7 days occurred less in the MT+ARG group (P = 0.040).
CONCLUSIONS: This study showed the safety and usefulness of argatroban immediately after MT, indicating that using argatroban after MT could prevent reocclusion of target artery without increasing bleeding complications.
METHODS: A total of 302 patients were divided into 2 groups: the MT with post argatroban (MT+ARG) group and the MT without post argatroban (MT-ARG) group. Baseline characteristics, time interval categories, and results of MT were reviewed. Outcome assessment with the National Institutes of Health Stroke Scale, modified Rankin Scale, TICI, reocclusion, and various complications were evaluated and compared between the 2 groups. Subgroup analysis was also performed for patients using tissue plasminogen activator or tirofiban.
RESULTS: Baseline characteristics and time intervals were similar for the 2 groups. The MT+ARG group showed significantly less occurrence of reocclusion at 24 hours and 7 days compared with the MT-ARG group (2.5% vs. 6.0%, P = 0.018; 4.2% vs. 8.2%, P = 0.020). However, there were no significant differences in incidence of complications such as brain hemorrhage between the 2 groups. In subgroup analysis with tissue plasminogen activator, the MT+ARG group showed less occurrence of reocclusion at 24 hours and 7 days compared with the MT-ARG group (P = 0.008 and P = 0.018, respectively). In subgroup analysis with tirofiban, reocclusion at 7 days occurred less in the MT+ARG group (P = 0.040).
CONCLUSIONS: This study showed the safety and usefulness of argatroban immediately after MT, indicating that using argatroban after MT could prevent reocclusion of target artery without increasing bleeding complications.