Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Mar 11;9(4):e14504.
doi: 10.1016/j.heliyon.2023.e14504. eCollection 2023 Apr.

Acute profound thrombocytopenia induced by tirofiban in stent assisted embolization of intracranial ruptured aneurysm-a rare case report

Bingda Piao  1 , Tong Li  1 , Hongliang Zhong  1 , Hongchao Yang  1 , Yang Wang  1 , He Liu  1
Affiliations
Case Reports

Acute profound thrombocytopenia induced by tirofiban in stent assisted embolization of intracranial ruptured aneurysm-a rare case report

Bingda Piao et al. Heliyon. .

Abstract

Objectives: Glycoprotein (GP) IIb/IIIa receptor antagonists (Tirofiban) are often used as antiplatelet agents in patients undergoing interventional therapy due to acute coronary syndrome and cerebrovascular diseases. Thrombocytopenia is a common complication of GP IIb/IIIa receptor antagonist, with an incidence of 1%-5%, whereas acute profound thrombocytopenia (platelet count<20 × 109/L) is extremely rare. We reported a case of acute profound thrombocytopenia due to tirofiban treatment to inhibit platelet aggregation during and after surgery in a patient who underwent stent-assisted embolization for ruptured intracranial aneurysm.

Case presentation: A 59-year-old female patient, who visited the Emergency Department of our hospital due to sudden headache, vomiting, and unconsciousness for 2 hours. Neurological examination: the patient was unconscious, the pupils on both sides had the same roundness, and the reflection on light was slow. The Hunt-Hess grade was IV. Head CT showed subarachnoid hemorrhage and Fisher's score was 3. We immediately implemented LVIS stent-assisted embolization, intraoperative heparinization, and intraoperative jailing technology to perform dense embolism on aneurysms. The patient was treated with mild hypothermia and Tirofiban 5mL/h intravenous pump. Since then, the patient had developed acute profound thrombocytopenia.

Conclusion: We reported a case of acute profound thrombocytopenia due to tirofiban treatment during and after interventional therapy. For patients after unilateral nephrectomy, we should pay more attention to avoid the occurrence of thrombocytopenia caused by abnormal metabolism of tirofiban, although the Laboratory examination showed normal results.

Keywords: Acute profound thrombocytopenia; GP IIb/IIIa receptor antagonist; Intracranial ruptured aneurysm; Tirofiban.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Head CT showing subarachnoid hemorrhage.
Fig. 2
Fig. 2
Perioperative plate change.
See this image and copyright information in PMC

References

    1. Ravikaran Patti M., Ankur Sinha M., Daniel Rodriguez M., et al. Severe thrombocytopenia due to intravenous tirofiban therapy [J] Am. J. Therapeut. 2019;26(4):e534–e536. doi: 10.1097/MJT.0000000000000756. - DOI - PubMed
    1. Dursunoglu D., Taskoylu O., Gur S., et al. Tirofiban-induced acute profound thrombocytopenia after primary angioplasty [J] Asian Cardiovasc. Thorac. Ann. 2013;21(1):74–76. doi: 10.1177/0218492312445142. - DOI - PubMed
    1. Elcioglu O.C., Ozkok A., Akpinar T.S., et al. Severe thrombocytopenia and alveolar hemorrhage represent two types of bleeding tendency during tirofiban treatment: case report and literature review [J] Int. J. Hematol. 2012;96(3):370–375. doi: 10.1007/s12185-012-1133-7. - DOI - PubMed
    1. Li Y., Li Q., Li F., et al. Evaluation of short- and long-term efficacy of combined intracoronary administration of high-dose adenosine and tirofiban during primary percutaneous coronary intervention [J] Acta Cardiol. Sin. 2016;32(6):640–648. doi: 10.6515/acs20151013i. - DOI - PMC - PubMed
    1. Yang M., Huo X., Miao Z., et al. Platelet glycoprotein IIb/IIIa receptor inhibitor tirofiban in acute ischemic stroke. [J]. Drugs. 2019;79(5):515–529. doi: 10.1007/s40265-019-01078-0. - DOI - PubMed

Publication types

LinkOut - more resources