PMID- 29771445
OWN - NLM
STAT- MEDLINE
DCOM- 20191106
LR  - 20191106
IS  - 2284-0729 (Electronic)
IS  - 1128-3602 (Linking)
VI  - 22
IP  - 9
DP  - 2018 May
TI  - Tirofiban combined with rt-PA intraarterial thrombolysis improves the 
      recanalization rate of acute middle cerebral artery occlusion in rabbits.
PG  - 2888-2895
LID - 14991 [pii]
LID - 10.26355/eurrev_201805_14991 [doi]
AB  - OBJECTIVE: To investigate the curative effect of tirofiban combined with 
      recombinant tissue-plasminogen activator (rt-PA) selective intra-arterial 
      thrombolysis on acute middle cerebral artery occlusion (MCAO). MATERIALS AND 
      METHODS: A total of 60 adult male Japanese white rabbits weighing 2.5-3.0 kg were 
      selected, and the acute cerebral infarction model was established via autologous 
      thromboembolism of middle cerebral artery. Rabbits were randomly divided into 4 
      groups: tirofiban group (Ti group, 5 mug/kg, n=15), rt-PA group (rt-PA group, 2 
      mg/kg, n=15), tirofiban + rt-PA group (Ti + rt-PA group, 3 mug/kg Ti + 1 mg/kg 
      rt-PA, n=15), and control group (Co group, n=15). The vascular recanalization 
      rate of intra-arterial thrombolysis was observed via digital subtraction 
      angiography (DSA), relative apparent diffusion coefficient (rADC) was observed 
      via diffusion-weighted imaging (DWI), and neurologic impairment was observed via 
      modified Bederson's scoring method. Rabbits were executed after 24 h, then the 
      volume of cerebral infarction was measured via triphenyl tetrazolium chloride 
      (TTC) staining, pathological examinations were performed using the optical 
      microscope and electron microscope, and immunohistochemical examination was 
      performed for brain-derived neurotrophic factor (BDNF). RESULTS: In Ti + rt-PA 
      group, the vascular recanalization rate was 91.7%, and there was no significant 
      bleeding in pathological examination. The rADC value, neurologic impairment score 
      and cerebral infarction area in Ti + rt-PA group were superior to those in Co 
      group, Ti group and rt-PA group. Immunohistochemical results of BDNF showed that 
      the expression of BDNF in Ti + rt-PA group was increased compared with those in 
      Co group, Ti group and rt-PA group. In Ti group and rt-PA group, there were 
      neuronal degeneration, moderate organelle swelling, moderate mitochondrial 
      swelling, enlarged volume and decreased number of cristae, and rupture and 
      disappearance of some mitochondrial cristae. In Co group, neuronal karyopyknosis, 
      nuclear chromatolysis and disappearance of cellular structure could be seen. 
      Results of electron microscopy showed that the shape of neuronal nuclei in Ti + 
      rt-PA group was basically normal, and there were mild mitochondrial swelling and 
      enlarged volume of cristae. CONCLUSIONS: Early application of tirofiban combined 
      with rt-PA in intra-arterial thrombolysis for ultra-early cerebral ischemia can 
      improve the recanalization rate of cerebral artery. The time of cerebral ischemia 
      and hypoxia is short, and the neuronal ischemia-reperfusion injury is mild, whose 
      thrombolysis effect is better than the single application of tirofiban or rt-PA.
FAU - Yu, Y-J
AU  - Yu YJ
AD  - Department of Emergency, Affiliated Hospital of Weifang Medical University, 
      Weifang, China. xiongwen1216@sina.com.
FAU - Xiong, W
AU  - Xiong W
LA  - eng
PT  - Journal Article
PL  - Italy
TA  - Eur Rev Med Pharmacol Sci
JT  - European review for medical and pharmacological sciences
JID - 9717360
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Recombinant Proteins)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - GGX234SI5H (Tirofiban)
SB  - IM
MH  - Acute Disease
MH  - Animals
MH  - Brain Ischemia/diagnostic imaging/drug therapy
MH  - Drug Therapy, Combination
MH  - Fibrinolytic Agents/*administration & dosage
MH  - Infarction, Middle Cerebral Artery/*diagnostic imaging/*drug therapy
MH  - Infusions, Intra-Arterial
MH  - Male
MH  - Rabbits
MH  - Random Allocation
MH  - Recombinant Proteins/administration & dosage
MH  - Stroke/diagnostic imaging/drug therapy
MH  - Thrombolytic Therapy/*methods
MH  - Tirofiban/*administration & dosage
MH  - Tissue Plasminogen Activator/*administration & dosage
MH  - Treatment Outcome
EDAT- 2018/05/18 06:00
MHDA- 2019/11/07 06:00
CRDT- 2018/05/18 06:00
PHST- 2018/05/18 06:00 [entrez]
PHST- 2018/05/18 06:00 [pubmed]
PHST- 2019/11/07 06:00 [medline]
AID - 14991 [pii]
AID - 10.26355/eurrev_201805_14991 [doi]
PST - ppublish
SO  - Eur Rev Med Pharmacol Sci. 2018 May;22(9):2888-2895. doi: 
      10.26355/eurrev_201805_14991.