A251 Long-term tirofiban administration is not associated with increased surgical risks after treatment of ruptured aneurysms

<h3>Introduction</h3> Thromboembolic complications following complex aneurysm treatments may be prevented by long-term administration of tirofiban. However, due to the potential risk of complications—particularly intraparenchymal hemorrhage—surgical aneurysm occlusion may be preferred in such cases. <h3>Aim of study</h3> In this retrospective, propensity score-matched cohort study, we investigated whether long-term administration of tirofiban is associated with an increased risk of intraparenchymal hemorrhage after subarachnoid hemorrhage (SAH). <h3>Method</h3> We included 99 patients who underwent interventional treatment for ruptured aneurysms between 2006 and 2024. Fifty-two patients were initially identified from our database who received tirofiban peri- and post-interventionally after endovascular treatment of ruptured complex aneurysms. The control group (n = 43) was selected using propensity score matching based on clinical and imaging morphological characteristics. Within the tirofiban group, further stratification was performed into short-term (≤7 days; n = 29) and long-term (&gt;7 days; n = 18) tirofiban administration. <h3>Results</h3> All intracranial bleeding complications occurred in association with surgical procedures. No significant differences in intraparenchymal hemorrhage were observed between the control group and patients receiving tirofiban for ≤7 days (p = 0.3) or &gt;7 days (p = 0.8). Surgery-associated subdural hematomas were rare (5%) and did not differ significantly between patients without tirofiban and those receiving tirofiban for ≤7 days (p = 0.8) or &gt;7 days (p = 0.2). <h3>Conclusion</h3> Long-term administration of tirofiban for more than 7 days following treatment of ruptured aneurysms is not associated with bleeding complications after intracranial surgery in patients with ruptured intracranial aneurysms. <h3>Conflict of Interest</h3> No