Abstract 417: Tandem Occlusion to TICI 3: A Case of Perioperative Tirofiban for Carotid Artery Stenting

Large vessel occlusions associated with ipsilateral high‐grade extracranial internal carotid artery (ICA) stenosis, also called tandem occlusions, remain under investigation for optimal management. The risk of in‐stent thrombosis is heightened for those who undergo carotid stenting in conjunction with mechanical thrombectomy (MT). Tirofiban, an intravenous (IV) antiplatelet agent functioning by binding the GIIb/IIIa receptors, inhibits platelet aggregation and has been used in cases of tandem occlusions to reduce the risk of in‐stent thrombosis. Unfortunately, the bleeding risk is elevated in patients who receive intraoperative antithrombotics during stenting procedures. This case discusses the use of perioperative tirofiban infusion during MT with acute angioplasty and stenting to manage a tandem occlusion.