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. 2026 Apr 17;105(16):e48070. doi: 10.1097/MD.0000000000048070

Prophylactic tirofiban versus oral dual antiplatelet therapy in patients undergoing endovascular treatment of intracranial aneurysms: A meta-analysis

Yvlu Miao a, Qiming Li b, Jiaqi Chen a, Zike Liu a,*
PMCID: PMC13095280  PMID: 41995519

Abstract

Background:

Endovascular treatment of intracranial aneurysms carries the risk of perioperative thromboembolism and bleeding, and the optimal prophylactic antiplatelet strategy remains unclear. This study aimed to evaluate the efficacy and safety of prophylactic tirofiban administration compared with oral dual antiplatelet (DAP) therapy.

Methods:

We searched PubMed, EMBASE, Cochrane Library, Web of Science, and Chinese National Knowledge Infrastructure databases for relevant studies up to August 2, 2023. All data analyses were conducted using RevMan 5.4 and Stata 14.0.

Results:

Eight randomized controlled trials with a total of 806 participants receiving endovascular treatment of intracranial aneurysms were included. The results indicated that prophylactic monotherapy with tirofiban was associated with significantly higher rate of good clinical outcome (risk ratio [RR]: 1.15, 95% confidence interval [CI]: 1.03–1.28, P = .01). It also reduced the incidence of thromboembolic (RR: 0.44, 95% CI: 0.26–0.74, P = .002) and hemorrhagic (RR: 0.47, 95% CI: 0.24–0.91, P = .03) events. Subgroup analyses further revealed the benefits of prophylactic tirofiban in combination with DAP therapy in reducing the incidence of hemorrhagic events, with a trend of reducing thromboembolic events. Meanwhile, prophylactic monotherapy with tirofiban reduced the incidence of thromboembolic events without increasing the incidence of hemorrhagic events. Sensitivity analyses demonstrated the robustness of all pooled results, but it was not possible to remove the negative impact of publication bias on the pooled results.

Conclusion:

These findings support the prophylactic administration of tirofiban to patients undergoing endovascular treatment of intracranial aneurysms, as it was associated with a significantly lower incidence of thromboembolic events without increasing the risk of hemorrhagic events. More studies are needed to determine differences between prophylactic monotherapy with tirofiban and prophylactic tirofiban in combination with DAP therapy.

Keywords: dual antiplatelet therapy, endovascular therapy, intracranial aneurysms, meta-analysis, tirofiban

1. Introduction

Intracranial aneurysm is caused by the structural dysplasia of the intracerebral artery wall, thereby causing the local blood vessel wall to expand outwards.[1] The prevalence in the general population is approximately 3%, therefore being the third most common reason for cerebrovascular accident after cerebral thrombosis and hypertensive cerebral hemorrhage.[2–4] Rupture of intracranial aneurysms is the most common cause of nontraumatic subarachnoid hemorrhage, accounting for 85% of cases.[5] Subarachnoid hemorrhage resulting from intracranial aneurysm rupture and the subsequent serious complications yield a poor prognosis, with a mortality rate of 44%[6] and a significant burden of disability and recurrence.[7]

Endovascular treatments such as stent-assisted coiling and flow diverters have gained widespread acceptance in the treatment of intracranial aneurysms.[8,9] Notably, stent placement and flow diverters are often associated with a higher risk of thromboembolic events, which are associated with poor clinical outcomes.[10,11] Adequate prevention of thromboembolic events is therefore critical during stent-assisted coil embolization and flow diversion of intracranial aneurysms.[12] Despite various preventive strategies, thromboembolic events remain a major perioperative complication.[11] Thromboembolic events have still been reported in up to 7% to 40% of individuals treated with dual antiplatelet (DAP), despite high on-treatment platelet reactivity.[13] Meanwhile, due to the irreversible inhibition of platelet aggregation, the frequency of symptomatic hemorrhage during aneurysm embolization also varies significantly.[14,15] Therefore, it is urgent to explore suitable antiplatelet strategies to compensate for the limitations faced by conventional oral DAP therapy.[16]

Glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors are widely regarded as the most effective class of antiplatelet therapies, with multiple clinical trials showing their adjuvant beneficial effects.[17,18] Tirofiban, a strong GP IIb/IIIa inhibitor, is becoming more used in the treatment of acute coronary syndromes due to its pharmacodynamic characteristics, such as a short onset of action and a short half-life.[19] Additionally, it is also utilized for rescue therapy of thromboembolic events during neurointerventional procedures.[20] To date, some studies have been conducted to investigate the prophylactic use of tirofiban in the endovascular treatment of intracranial aneurysms.[21,22] Although a recent meta-analysis[23] analyzed the safety and efficacy of prophylactic tirofiban administration, different types of studies reduced the comparability between studies.

Therefore, definitive studies are needed to demonstrate the efficacy and safety of prophylactic administration of tirofiban versus prophylactic use of DAP medications. This meta-analysis aimed to fill the gap by including only randomized controlled trials (RCTs).

2. Materials and methods

This study was rigorously conducted according to the recommendations made by the Cochrane Collaboration,[24] hence ensuring its transparency and reliability. We then reported this meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist.[25] The present meta-analysis did not require ethical approval. This study is not registered in the database.

2.1. Literature retrieval

We systematically searched 5 electronic databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, and Chinese National Knowledge Infrastructure for relevant studies from their inception to August 2, 2023. We used text words and medical subject headings, including “Intracranial Aneurysm” and “Tirofiban,” to build search strategies. Details of the search strategies were summarized in Table S1, Supplemental Digital Content, https://links.lww.com/MD/R592. Only studies published in English and Chinese were considered, while we did not impose restriction on publication status. In addition, we manually checked the reference lists of eligible studies and previous meta-analyses.

2.2. Inclusion and exclusion criteria

We developed inclusion criteria based on the PICOS acronym as follows: patients (P): adult patients (aged ≥ 18 years) diagnosed with intracranial aneurysms and scheduled for endovascular treatment. Studies, including patients with ruptured or unruptured aneurysms were eligible; intervention (I): patients received prophylactic administration of tirofiban alone or in combination with oral DAP therapy in the endovascular treatment of intracranial aneurysms; comparison (C): patients received prophylactic use of oral DAP; outcomes (O): studies reported at least one of clinical outcomes, hemorrhagic events, and thromboembolic events; and study design (S): only RCTs were considered for inclusion. Studies were excluded if they: had ineligible study designs, such as case reports, case series, observational studies, and reviews; were duplicate publications or overlapping patient populations; or had insufficient data for extraction.

2.3. Study selection

Two authors (Yvlu Miao and Zike Liu) independently conducted the process of study selection following 3 steps. First, duplicate studies were omitted through EndNote software. Second, the 2 authors independently screened the titles and abstracts against the predefined inclusion and exclusion criteria. Finally, the same 2 reviewers independently assessed the full texts of potentially eligible studies to make final inclusion decisions. A standardized data extraction form was piloted and used to ensure consistent application of the inclusion criteria. Any disagreements between the reviewers at any stage of the selection process were resolved through discussion until consensus was reached. When consensus could not be achieved, a third senior reviewer was consulted to make the final decision.

2.4. Data extraction

Two researchers (Qiming Li and Jiaqi Chen) independently extracted essential information from each eligible study using a predesigned data extraction form. Specifically, the following data were extracted, including the first author’s name, year of publication, country, number of patients, gender ratio, average age of patients, mean diameter of aneurysms, Hunt-Hess grade of aneurysms, and detailed interventions and outcomes. We also extracted detailed information on the risk of bias of each eligible study. Any differences between the 2 authors were resolved through discussion.

2.5. Definition of outcome

This meta-analysis considered good clinical outcome as the primary outcome and hemorrhagic and thromboembolic complications as secondary outcomes. Good clinical outcome was defined as a modified Rankin scale score of ≤2 at long-term (≥3 months) follow-up or a Glasgow Outcome Score of ≥4 at discharge.[23] Any event meeting one of the following criteria was defined as a hemorrhagic event: intra-procedural contrast extravasation on DSA, new intracranial hemorrhage on postprocedural head computed tomography/magnetic resonance imaging with or without certain clinical symptoms, and severe gastrointestinal hemorrhage.[16] Any event fulfilling one of the following criteria was defined as a thromboembolic event: in-stent filling defect, partial or complete occlusion of the proximal or distal intracranial arteries on DSA, and periprocedural thromboembolism symptoms with or without cerebral infarction on postprocedural magnetic resonance imaging/computed tomography.[16]

2.6. Risk of bias assessment

Two authors (Zike Liu and Qiming Li) independently assessed the risk of bias of each eligible study using the revised Cochrane risk of bias tool (RoB2)[26] from 5 domains. The risk of bias for each domain will be rated as high, some concerns, low, or no information, based on the actual information reported by the study. The overall risk of bias of individual studies will be rated as low, some concern, or high. Any disagreements between the 2 authors were resolved through discussion.

2.7. Data analysis

RevMan 5.4 software was adopted for conducting meta-analysis. Results were reported as risk ratio (RR) accompanied by 95% confidence intervals (CI), since all outcomes are dichotomous. We used the Cochran Q and inconsistency factor (I2) to examine statistical heterogeneity between studies.[27,28] If heterogeneity was low (I2 ≤ 50% and P > .1), summary effects were calculated using a fixed-effects model; on the contrary, if heterogeneity was high (I2 > 50% and P < .1), a random-effects model was chosen. The subgroup analysis was designed according to how the study administered prophylactic tirofiban (monotherapy vs combination therapy of tirofiban and conventional DAP therapy). Notably, these subgroup analyses were predefined prior to data extraction and analysis based on clinical and pharmacological hypotheses. The division into tirofiban monotherapy and combination therapy subgroups was motivated by 2 key rationales: first, the unique pharmacodynamic characteristics of tirofiban, such as its rapid onset, reversible binding, and short half-life, differ from those of oral DAP therapy agents. These differences lead to distinct safety-efficacy profiles for single-agent versus combined regimens. Second, both strategies are widely adopted in clinical practice, and their comparative value in endovascular aneurysm treatment remains unclear, necessitating targeted subgroup evaluation to inform clinical decision-making. We first visually inspected the outline of the funnel plot to qualitatively assess the risk of publication bias.[29] Then, we used Stata 14.0 software to perform Egger’s test, aiming to test the symmetry of the funnel plot to further quantitatively assess the risk of publication bias. Meanwhile, sensitivity analysis was performed using Stata 14.0 software with the leave-one-out strategy.

3. Results

3.1. Search results

The detailed process of study selection is shown in Figure 1. Among a total of 70 studies, 60 studies were screened after removing 7 duplicates and 3 registries of clinical trials. Then, 50 studies were excluded because they were reviews (n = 11), enrolled ineligible patients (n = 1), had ineligible control designs (n = 2), had ineligible study designs (n = 5), and were unrelated to the topic (n = 31). After 10 full texts were assessed for eligibility, 2 irrelevant studies were excluded for 2 reasons: ineligible treatment (n = 1) and ineligible study design (n = 1). Finally, 8 studies[30–37] were included for final data analysis.

Figure 1.

Figure 1.

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PRISMA diagram of study screening and selection. CNKI = Chinese National Knowledge Infrastructure, PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

3.2. Study characteristics

Table S2, Supplemental Digital Content, https://links.lww.com/MD/R592, shows the baseline characteristics of the 8 included studies. All of these studies were published between 2015 and 2023 and were conducted in China. A total of 806 participants, 394 in the intervention group and 412 in the control group, were included in this meta-analysis. The mean age of all patients was 54.24 years. Five studies[30–34] assigned participants in the intervention group to receive prophylactic monotherapy with tirofiban, while the other 3 studies[35–37] designed prophylactic tirofiban in combination with oral DAP therapy.

3.3. Risk of bias

Figure 2 shows the detailed results of the risk of bias assessment for all included studies. Of the 8 RCTs, 5 studies[30,31,33–35] showed low risk in the randomization process, while the other 3 studies[32,35,37] had some concerns as they did not report the details of generating the random sequence and how the sequence was concealed. Only 1 study[30] was low risk because of appropriate blinding, and the remaining 7 studies[31–37] were regarded as some concerns because of lack of details. Finally, the overall risk of bias of 1 study was rated as high, 4 studies were rated as low, and 3 studies were rated as having some concerns.

Figure 2.

Figure 2.

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Risk of bias assessment: (A) traffic-light plot and (B) summary plot.

3.4. Meta-analysis

3.4.1. Good clinical outcomes

Three studies[30,31,33] with a total of 227 participants underwent an endovascular treatment of intracranial aneurysms reported the rate of good clinical outcome. As shown in Figure 3, the heterogeneity test showed low statistical heterogeneity (I2 = 35%, P = .21), so we adopted a fixed-effects model for meta-analysis. The summary effect showed that prophylactic monotherapy with tirofiban significantly increased the rate of good clinical outcome compared with oral DAT therapy alone (RR: 1.15, 95% CI: 1.03–1.28, z = 2.49, P = .01). Furthermore, sensitivity analysis revealed the robustness of the summary effects, as shown in Figure S1A, Supplemental Digital Content, https://links.lww.com/MD/R592.

Figure 3.

Figure 3.

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Meta-analysis of rate of good clinical outcome between prophylactic tirofiban administration and oral DAP therapy. CI = confidence interval, DAP = dual antiplatelet, M–H = Mantel–Haenszel.

3.4.2. Thromboembolic events

All studies with a total of 806 patients were enrolled to compare the incidence of thromboembolic events in the 2 groups. As no statistical heterogeneity between studies was detected (I2 = 0%, P = .64) in the overall data analysis, a fixed-effects model was used for meta-analysis. As shown in Figure 4, the summary effect reflected that the incidence of thromboembolic events in the prophylactic tirofiban administration group was significantly lower than that of the oral DAP therapy alone group (RR: 0.44, 95% CI: 0.26–0.74, P = .002). The sensitivity analysis demonstrated the robustness of the pooled effect after item-by-item removal, as shown in Figure S1B, Supplemental Digital Content, https://links.lww.com/MD/R592. Furthermore, subgroup analyses showed that prophylactic monotherapy with tirofiban (I2 = 0.0%, P = .73; RR: 0.43, 95% CI: 0.23–0.81, z = 2.62, P < .001) was associated with significantly lower incidence of thromboembolic events compared with oral DAP therapy alone (as shown in Fig. 4). In addition, although the pooled result did not reach a significant level, a beneficial trend towards reducing the incidence of thromboembolic events was found in patients receiving prophylactic tirofiban administration combined with oral DAP therapy (I2 = 58%, P = .09; RR: 0.45, 95% CI: 0.18–1.15, z = 1.66, P = .10). The interaction between subgroups was not statistically significant (P = .93), indicating the reliability of the results of the subgroup analysis.

Figure 4.

Figure 4.

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Meta-analysis of the incidence of thromboembolic events between prophylactic tirofiban administration and oral DAP therapy. CI = confidence interval, DAP = dual antiplatelet, M–H = Mantel–Haenszel.

3.4.3. Hemorrhagic events

All studies with a total of 806 patients were enrolled to compare the risk of hemorrhagic events in the 2 groups. As no statistical heterogeneity between studies was detected (I2 = 10%, P = .35) in the overall data analysis, a fixed-effects model was used for meta-analysis. As shown in Figure 5, the summary effect reflected that the incidence of thromboembolic events of the prophylactic tirofiban administration group was significantly lower than that of the oral DAP therapy alone group (RR: 0.47, 95% CI: 0.24–0.91, P = .03). As shown in Figure S1C, Supplemental Digital Content, https://links.lww.com/MD/R592, the sensitivity analysis demonstrated the robustness of the pooled effect after item-by-item removal. Subgroup analyses showed that prophylactic tirofiban in combination with DAP therapy (I2 = 0%, P = .74; RR: 0.19, 95% CI: 0.05–0.67, z = 2.57, P = .01) rather than prophylactic monotherapy with tirofiban (I2 = 0%, P = .49; RR: 0.82, 95% CI: 0.35–1.91, z = 0.46, P = .65) was associated with a significantly lower incidence of hemorrhagic events compared with oral DAP therapy alone (as shown in Fig. 4). The interaction between subgroups was not statistically significant (P = .06), indicating the reliability of the results of the subgroup analysis.

Figure 5.

Figure 5.

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Meta-analysis of the incidence of hemorrhagic events between prophylactic tirofiban administration and oral DAP therapy. CI = confidence interval, DAP = dual antiplatelet, M–H = Mantel–Haenszel.

3.5. Publication bias

As shown in Figure S2, Supplemental Digital Content, https://links.lww.com/MD/R592, the contours of all funnel plots were asymmetrical, indicating a high risk of publication bias for all pooled effects. However, Egger’s test for testing the symmetry of funnel plots did not confirm the judgment of visual inspection, with P values of .08 and .163 for thromboembolic and hemorrhagic events, respectively. Of note, the P value for Egger’s test for good clinical outcome was not reported due to insufficient data. These results suggest that all pooled results are subject to publication bias.

4. Discussion

This meta-analysis is the first to exclusively focus on RCTs assessing the efficacy and safety of prophylactic tirofiban administration compared with oral DAP therapy in patients undergoing endovascular treatment for intracranial aneurysms. Analyzing 8 eligible RCTs with 809 participants, the results indicated that prophylactic monotherapy with tirofiban led to a higher rate of favorable clinical outcomes. Additionally, the combination of prophylactic tirofiban with DAP therapy demonstrated a lower incidence of hemorrhagic events compared with DAP therapy alone and also displayed a positive trend towards reducing the incidence of thromboembolic events. However, prophylactic monotherapy with tirofiban showed similar potential in preventing hemorrhagic events as DAP therapy alone, while significantly reducing the incidence of thromboembolic events.

The distinct pharmacodynamics and procedural pathophysiology explain the counterintuitive finding that tirofiban-DAP combination therapy, despite being a more intensive regimen, significantly reduces hemorrhagic events compared with DAP therapy alone. First, the superior safety profile of the tirofiban-DAP combination may be attributed to the more predictable and rapid-onset platelet inhibition provided by tirofiban. Unlike oral P2Y12 inhibitors, which can have variable absorption and a delayed onset of action, taking up to 4 hours to achieve sufficient platelet inhibition,[38] tirofiban is a non-peptide platelet GP IIb/IIIa receptor antagonist that generally begins to take effect within 5 minutes.[39] This rapid and potent inhibition during the most vulnerable periprocedural period may prevent the formation of unstable, friable platelet-rich thrombi.[40] The formation and subsequent dislodgement of such fragile thrombi could lead to distal microvascular occlusion, triggering a cascade of events that culminate in hemorrhagic transformation.[41] Second, a significant contributor to periprocedural hemorrhage in neurointerventions is not spontaneous bleeding, but bleeding that follows an ischemic insult.[41] It is plausible that an initial, subclinical micro-thromboembolism, caused by inadequate or delayed platelet inhibition under DAP therapy alone, leads to focal vessel occlusion and endothelial damage. Subsequent reperfusion of these ischemic areas can then result in vessel rupture and hemorrhage from the compromised vasculature.[41] By providing more potent and consistent intra-procedural platelet inhibition, the tirofiban-DAP combination may more effectively prevent the initial thromboembolic nidus, thereby indirectly but powerfully reducing the risk of subsequent hemorrhagic complications.

Thromboembolic complications remain a major challenge in patients undergoing endovascular therapy for intracranial aneurysms despite the prophylactic use of antiplatelet therapy as premedication.[42] In addition, administration of DAP medications at least 3 to 5 days before endovascular therapy may also increase the risk of intracranial hemorrhage, with a reported incidence of 18.91%.[43] Since GP IIb/IIIa receptors are a common pathway for platelet aggregation and thrombus formation,[44] GP IIb/IIIa inhibitors have attracted more attention. Abciximab, tirofiban, and eptifibatide are the 3 GP IIb/IIIa inhibitors that are currently available; nevertheless, some studies have shown that abciximab and eptifibatide may cause life-threatening intracerebral hemorrhage.[45–47] Additionally, abciximab binds to GP IIb/IIIa receptors in an irreversible manner, inhibiting the activity of platelets for approximately 48 hours after the interruption of the infusion.[48] So, tirofiban is the most preferred GP IIb/IIIa inhibitor for the treatment of thromboembolic events. Tirofiban has a high affinity for GP IIb/IIIa receptors and has a rapid onset of action (>95% inhibition of platelets within 10 minutes of administration),[40] features that are crucial for its safety profile. Unlike abciximab, tirofiban’s reversible binding and short half-life create a transient “platelet anesthesia” effect.[49] This allows for profound inhibition during the procedure while permitting rapid recovery thereafter, thereby minimizing the window of vulnerability for serious bleeding, especially if subsequent surgical interventions are required.[50] All of these benefits ultimately contributed to improved clinical outcome, with 91.38% of patients receiving prophylactic tirofiban having good clinical outcome compared with 79.28% of patients receiving prophylactic DAP therapy.

Furthermore, regarding the optimal dosing regimen, our subgroup findings are supported by emerging evidence. A study found that a lower dosage of tirofiban for stent-assisted coiling could effectively reduce the risk of intracranial hemorrhage, especially the risk of early postoperative rebleeding, without increasing thromboembolic risk.[51] This suggests that the high hemorrhagic event rate reported in some studies[52] might be related to higher bolus doses and highlights the importance of dose optimization in balancing efficacy and safety.

The current meta-analysis obtained results consistent with the prior meta-analysis by Xiang et al,[23] which also reported that prophylactic tirofiban administration was associated with a higher rate of good clinical outcome and a lower incidence of thromboembolic and hemorrhagic events. However, this meta-analysis has 2 major advantages compared with previous meta-analyses. RCTs have a stronger ability to control for confounding factors than observational studies, so meta-analyses of RCTs are considered the gold standard for evaluating the effectiveness and safety of different treatments.[26] The first strength of the current meta-analysis is that it included only RCTs to enhance the level of evidence and thereby greatly increase the reliability of the results. Although the previous meta-analysis has evaluated the potential of prophylactic administration of tirofiban in preventing perioperative complications in patients undergoing endovascular treatment of intracranial aneurysms, due to variable administration methods in practice, consensus about the use of prophylactic tirofiban is still challenging.[15] From this perspective, this meta-analysis conducted subgroup analysis to separately evaluate the potential of prophylactic monotherapy with tirofiban and prophylactic tirofiban combined with oral DAP medications to provide more accurate information for clinical decision-making.

This meta-analysis has many limitations. First, a total of 8 RCTs were included in the final data analysis; however, 7 studies included only a limited number of participants (<100 participants in total), and only 1 study had a total sample size of 313. Therefore, the results of individual studies will be inevitably affected by insufficient sample size, thereby negatively affecting the reliability of pooled results. Second, we employed heterogeneity examination to assess heterogeneity between studies; we were unable to eliminate variations between different studies, despite detecting low statistical heterogeneity in all pooled analyses. Nonetheless, we performed sensitivity analysis and demonstrated the robustness of the pooled results. Third, this meta-analysis also assessed the rate of good clinical outcomes. However, assessment of good clinical outcomes was inconsistent across studies, with outcomes assessed using modified Rankin scale scores or Glasgow Outcome Scores in different studies. Fourth, various drug administrations could also negatively affect the reliability of the results. Based on the limited data, we still performed subgroup analysis to evaluate the role of prophylactic monotherapy with tirofiban and prophylactic tirofiban in combination with oral DAP therapy, thereby enhancing the reliability of the results to a certain extent. Fifth, all included RCTs in this meta-analysis were conducted in China. While this enhances the internal consistency of the study population, it may limit the generalizability of our findings to other ethnicities and healthcare settings. Future multi-center, international trials are needed to validate the efficacy and safety of prophylactic tirofiban in a broader global population.

5. Conclusion

The current meta-analysis suggests that prophylactic administration of tirofiban, with a lower incidence of thromboembolic events and no increase in the incidence of hemorrhagic events, should be an effective alternative to prophylactic use of DAP alone in patients undergoing endovascular treatment of intracranial aneurysms. Furthermore, prophylactic tirofiban in combination with DAP therapy had significant benefits, with significantly lower incidences of hemorrhagic events and a beneficial trend towards reducing the incidence of thromboembolic events. However, future studies should further evaluate differences between prophylactic monotherapy with tirofiban and prophylactic tirofiban in combination with DAP therapy.

Author contributions

Data curation: Yvlu Miao, Qiming Li, Jiaqi Chen, Zike Liu.

Formal analysis: Yvlu Miao, Qiming Li, Jiaqi Chen, Zike Liu.

Supplementary Material

medi-105-e48070-s001.docx (679.2KB, docx)

Abbreviations:

CI
confidence interval
DAP
dual antiplatelet
GP
glycoprotein
RCT
randomized controlled trial
RR
risk ratio

The authors have no funding and conflicts of interest to disclose.

All data generated or analyzed during this study are included in this published article (and its supplementary information files).

Supplemental Digital Content is available for this article.

How to cite this article: Miao Y, Li Q, Chen J, Liu Z. Prophylactic tirofiban versus oral dual antiplatelet therapy in patients undergoing endovascular treatment of intracranial aneurysms: A meta-analysis. Medicine 2026;105:16(e48070).

YM and ZL contributed to this article equally.

Contributor Information

Yvlu Miao, Email: miaoyulu@aliyun.com.

Qiming Li, Email: 596029877@qq.com.

Jiaqi Chen, Email: cathychan0769@foxmail.com.

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