Tirofiban-induced acute profound thrombocytopenia in endovascular therapy for acute ischemic stroke: a rare case report

Abstract

Abstract Background Studies have shown that tirofiban (a glycoprotein IIb/IIIa receptor antagonist) is effective in the endovascular treatment of cerebrovascular diseases. However, it has also been reported that tirofiban can cause thrombocytopenia. Here we report a rare case of tirofiban-induced acute profound thrombocytopenia in a patient undergoing endovascular therapy for acute ischemic stroke. Case report A 39-year-old male patient was sent to the emergency department of our hospital due to a sudden onset of disturbance in consciousness, aphasia and right hemiparesis for 2 h. Computed tomography angiogram (CTA) revealed an occlusion of the left middle cerebral artery. He was directed into emergency embolectomy with stent implantation under digital subtraction angiography (DSA) guidance. Due to the extensive clot formation during surgery, a bolus of 20 ml tirofiban was slowly injected through the guiding catheter. Approximately two hours after the infusion, the patient developed acute profound thrombocytopenia. Conclusion Tirofiban-induced thrombocytopenia after drug infusion may occur acutely and without any bleeding manifestations. There may be a clinical correlation between the loading dose of tirofiban and the occurrence of acute profound thrombocytopenia. Clinicians should maintain high caution for the potential crash of platelet levels when this drug is administered during procedures.

Keywords

• Tirofiban
• Thrombocytopenia
• Endovascular