title: Intraarterial tirofiban thrombolysis for thromboembolisms during coil embolization for ruptured intracranial aneurysms.
abstract: OBJECTIVE
  Thromboembolus can occur during endovascular coil embolization. The aim of our study was to show our experience of intraarterial (IA) tirofiban infusion for thromboembolism during coil embolization for ruptured intracranial aneurysms.
  
  
  METHODS
  This retrospective analysis was conducted in 64 patients with ruptured aneurysms who had emergent endovascular coil embolization from May 2007 to April 2011 at a single institute. Thromboembolic events were found in ten patients (15.6%). Anticoagulation treatment with intravenous heparin was started after the first coil deployment in ruptured aneurysmal sac. When a thrombus or embolus was found during the procedure, we tried to resolve them without delay with an initial dosage of 0.3 mg of tirofiban up to 1.2 mg.
  
  
  RESULTS
  Three patients of four with total occlusion had recanalizations of thrombolysis in myocardial infarction (TIMI) grade III and five of six with partial occlusion had TIMI grade III recanalizations. Eight patients showed good recovery, with modified Rankin Scale (mRS) score of 0 and one showed poor outcome (mRS 3 and 6). There was no hemorrhagic or hematologic complication.
  
  
  CONCLUSIONS
  IA tirofiban can be feasible when thromboembolic clots are found during coil embolization in order to get prompt recanalization, even in patients with subarachnoid hemorrhage.
authors.affiliation: Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
authors.forename: Jin Sue
authors.initials: JS
authors.lastname: Jeon
authors.forename: Seung Hun
authors.initials: SH
authors.lastname: Sheen
authors.forename: Gyojun
authors.initials: G
authors.lastname: Hwang
authors.forename: Suk Hyung
authors.initials: SH
authors.lastname: Kang
authors.forename: Dong Hwa
authors.initials: DH
authors.lastname: Heo
authors.forename: Yong Jun
authors.initials: YJ
authors.lastname: Cho