Study on application effect of tirofiban in stent assisted intracranial aneurysm embolization and its influence on serum sICAM-1 levels
Objective To investigate the application of tirofiban in stent assisted intracranial aneurysm embolization and its influenece on serum soluble intercellular adhesion molecule-1(sICAM-1)levels.Methods 60 patients planned to undergo stent assisted intracranial aneurysm embolization treatment were selected as the research subjects.The patients were numbered by random number table method at admission,with odd-numbered patients included in the low-dose group and even-numbered patients included in the high-dose group.Patients in the low-dose group received 0.15 μg/(kg·min)tirofiban intravenous pumped for 3 min,and those in the high-dose group received 3 μg/(kg·min)tirofiban intravenous pumped for 3 min.All patients received stent assisted intracranial aneurysm embolization under general anesthesia.The clinical efficacy,coagulation function[platelet count(PLT),activated partial thromboplastin time(APTT)],postoperative adverse events and serum sICAM-1 level were compared between the two groups.Results At 21 d after surgery,there was no significant difference in the rate of new obstruction and stent patency between the two groups(P>0.05).5 patients with stent obstruction in the low-dose group and 6 patients with stent obstruction in the high-dose group were graded by the Raymond method,and there was no statistically significant difference in the comparison of Raymond grading between the two groups(P>0.05).At 21 d after surgery,there was no significant difference in PLT and APTT between the two groups(P>0.05).The incidence of postoperative adverse events in low-dose group was 6.67%,which was lower than 26.67%in high-dose group,and the difference was statistically significant(P<0.05).There was no significant difference in serum sICAM-1 level between the two groups before surgery and at 1 d after surgery(P>0.05).At 7 and 21 d after surgery,the serum sICAM-1 levels in low-dose group were(145.73±2.21)and(131.82±1.43)ng/ml,which were higher than(139.83±1.84)and(127.83±1.32)ng/ml in high-dose group,respectively,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of low-dose tirofiban in stent assisted intracranial aneurysms embolization is similar to that of high-dose tirofiban,but the bleeding risk of low-dose tirofiban is lower,which is related to the higher level of serum sICAM-1.
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