{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T08:14:33Z","timestamp":1780474473569,"version":"3.54.1"},"reference-count":26,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2025,11,28]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tirofiban is widely used in ischemic stroke, but its safety and efficacy during stenting of perforator-rich intracranial arteries are unclear. We speculate that prophylactic use of an intra-arterial bolus of tirofiban followed by intravenous maintenance after stenting of perforator-rich intracranial arteries may be safe and effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed patients with atherosclerotic stenosis treated with stenting for perforator-rich intracranial arteries between January 2021 and December 2024. The tirofiban group received tirofiban 10\u2009\u00b5g\/kg immediately after stenting via a microcatheter into the target artery, followed by intravenous infusion of 0.1\u2009\u00b5g\/kg\/min for 24\u201372 hours, while controls received dual oral antiplatelet therapy. The primary efficacy endpoints were the incidence of acute in-stent thrombosis (AST) within 30\u2009min after stent implantation and ischemic stroke in the target vascular territory within 7\u2009days post-procedure. Secondary endpoints included modified Rankin Scale score at 6 months and the incidence of in-stent restenosis. The primary safety endpoint was the incidence of symptomatic intracranial hemorrhage within 7\u2009days post-procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>150 patients were included: 72 received tirofiban and 78 received dual antiplatelets. AST occurred in 2.8% of the tirofiban group versus 12.8% of controls (RR 0.89; 95%\u2009CI 0.82 to 0.98; P=0.02). AST was associated with uncontrolled diabetes, aspirin or clopidogrel resistance, and final residual stenosis. Recurrent ischemic stroke rates at 7\u2009days (2.8% vs 6.4%; P=0.45), symptomatic intracranial hemorrhage (1.4% vs 1.3%), 6\u2009month in-stent restenosis (7.1% vs 9.0%; P=0.68), and modified Rankin Scale scores at 6 months showed no significant differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Periprocedural intra-arterial with intravenous tirofiban reduced early AST, without increasing the risk of hemorrhage, for stenting of perforator-rich intracranial arteries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnis-2025-024471","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:35:22Z","timestamp":1765535722000},"page":"jnis-2025-024471","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Safety and efficacy of sequential intra-arterial and intravenous administration of tirofiban during the periprocedural period of stenting in perforator-rich intracranial arteries"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1045-7153","authenticated-orcid":false,"given":"Linlin","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Neurology, Beijing Geriatric Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7722-6986","authenticated-orcid":false,"given":"Zhiyong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Geriatric Hospital, Beijing, China"},{"name":"Neuromedicine Center, Beijing Geriatric Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"2025121202351511000_jnis-2025-024471v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(21)00376-8"},{"key":"2025121202351511000_jnis-2025-024471v1.2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.003508"},{"key":"2025121202351511000_jnis-2025-024471v1.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1693"},{"key":"2025121202351511000_jnis-2025-024471v1.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62038-3"},{"key":"2025121202351511000_jnis-2025-024471v1.5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.12000"},{"key":"2025121202351511000_jnis-2025-024471v1.6","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1161\/STROKEAHA.118.020840","article-title":"Hemodynamic Markers in the Anterior Circulation as Predictors of Recurrent Stroke in Patients With Intracranial Stenosis","volume":"50","author":"Wabnitz","year":"2019","journal-title":"Stroke"},{"key":"2025121202351511000_jnis-2025-024471v1.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023996"},{"key":"2025121202351511000_jnis-2025-024471v1.8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.12829"},{"key":"2025121202351511000_jnis-2025-024471v1.9","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000380948.85926.3C"},{"key":"2025121202351511000_jnis-2025-024471v1.10","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2020.00492","article-title":"Safety and Efficacy of Tirofiban in Rescue Treatment for Acute Intracranial Intraprocedural Stent Thrombosis","volume":"11","author":"Sun","year":"2020","journal-title":"Front Neurol"},{"key":"2025121202351511000_jnis-2025-024471v1.11","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000209217","article-title":"Efficacy and Safety of Tirofiban Before Stenting for Symptomatic Intracranial Atherosclerotic Stenosis","volume":"102","author":"Zhang","year":"2024","journal-title":"Neurology (ECronicon)"},{"key":"2025121202351511000_jnis-2025-024471v1.12","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001446"},{"key":"2025121202351511000_jnis-2025-024471v1.13","first-page":"166","article-title":"Preliminary results of endovascular stent-assisted angioplasty for symptomatic middle cerebral artery stenosis","volume":"26","author":"Lee","year":"2005","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025121202351511000_jnis-2025-024471v1.14","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-020-01864-4"},{"key":"2025121202351511000_jnis-2025-024471v1.15","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7203"},{"key":"2025121202351511000_jnis-2025-024471v1.16","doi-asserted-by":"crossref","first-page":"1601","DOI":"10.1161\/STROKEAHA.120.033551","article-title":"Intravenous Tirofiban Infusion After Angioplasty and Stenting in Intracranial Atherosclerotic Stenosis-Related Stroke","volume":"52","author":"Baek","year":"2021","journal-title":"Stroke"},{"key":"2025121202351511000_jnis-2025-024471v1.17","doi-asserted-by":"crossref","unstructured":"Sun Z , Huang S , Li W , et al . Preoperative and intraoperative tirofiban during endovascular thrombectomy in large vessel occlusion stroke due to large artery atherosclerosis. Euro J of Neurology 2024;31. doi:10.1111\/ene.16419","DOI":"10.1111\/ene.16419"},{"key":"2025121202351511000_jnis-2025-024471v1.18","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014185"},{"key":"2025121202351511000_jnis-2025-024471v1.19","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A8374"},{"key":"2025121202351511000_jnis-2025-024471v1.20","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019193"},{"key":"2025121202351511000_jnis-2025-024471v1.21","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.532713"},{"key":"2025121202351511000_jnis-2025-024471v1.22","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.043634"},{"key":"2025121202351511000_jnis-2025-024471v1.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-023-03110-z","article-title":"In-stent restenosis and stented-territory infarction after carotid and vertebrobasilar artery stenting","volume":"23","author":"Ryu","year":"2023","journal-title":"BMC Neurol"},{"key":"2025121202351511000_jnis-2025-024471v1.24","doi-asserted-by":"publisher","DOI":"10.1007\/s40292-023-00562-9"},{"key":"2025121202351511000_jnis-2025-024471v1.25","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1080\/01616412.2024.2337518","article-title":"Enterprise stents for the treatment of symptomatic non-acute intracranial artery stenosis disease: safety and efficiency evaluation","volume":"46","author":"Ma","year":"2024","journal-title":"Neurol Res"},{"key":"2025121202351511000_jnis-2025-024471v1.26","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000128018.57526.3a"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jnis-2025-024471","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T10:35:25Z","timestamp":1765535725000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/jnis-2025-024471"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":26,"alternative-id":["10.1136\/jnis-2025-024471"],"URL":"https:\/\/doi.org\/10.1136\/jnis-2025-024471","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}