Treatments
stroke, angioplasty
STROKE, DEEP VEIN THROMBOSIS
Eligible subjects were randomly assigned to the tirofiban group or the control group. The tirofiban group received intravenous bolus and continuous infusion of tirofiban, while the control group received saline placebo. Tirofiban was administered as a 10 μg/kg bolus, followed by a maintenance infusion of 0.15 μg/kg/min for up to 24 h. The specific endovascular treatment techniques, such as stent-retrieval, local aspiration, angioplasty, and stenting, were performed based on the neurointerventionalists' discretion. However, the use of intra-arterial thrombolytics (e.g., alteplase or urokinase), tirofiban, rescue drug, or other glycoprotein IIb/IIIa inhibitors was not recommended. The rescue drug, available in the study kits, could be used if antegrade blood flow could not be maintained after angioplasty and/or stenting, following the same administration protocol as the study drug. Patients experiencing deteriorating symptoms underwent an immediate repeat of the routine or dual-source head CT scan. For those patients whose condition remained stable, a routine or dual-source head CT scan was conducted 20 h post-procedure. At the 20th hour, all patients without contraindications received oral antiplatelet therapy with aspirin and/or clopidogrel tablets. Patients undergoing angioplasty/stenting received dual-antiplatelet therapy with aspirin and clopidogrel, while others received mono-antiplatelet therapy. The study drug was discontinued at the 24th hour, and subsequent patient management followed the current stroke management guidelines. Intravenous heparin could be used during the thrombectomy procedure, as determined by the operator. Additionally, subcutaneous heparin or low-molecular-weight heparin could be administered post-procedure for deep vein thrombosis prophylaxis. However, the use of other anticoagulants or antiplatelet agents was prohibited within the first 24 h post-randomization.