Adjunct tirofiban treatment after successful endovascular thrombectomy recanalisation in acute anterior circulation ischaemic stroke (ATTRACTION): protocol of a multicentre, prospective, double-blinded, randomised trial

Background Successful recanalisation without functional independence is a frequent phenomenon following endovascular thrombectomy (EVT) for large vessel occlusion (LVO) stroke. Aim To demonstrate the safety and efficacy of adjunct tirofiban therapy after EVT in patients with anterior circulation LVO stroke achieving successful recanalisation, defined as modified Thrombolysis In Cerebral Infarction 2b–3. Design The study of adjunct tirofiban treatment after successful EVT recanalisation (ATTRACTION: Adjunct Tirofiban Treatment after Successful Endovascular Thrombectomy Recanalisation in Acute Anterior Circulation Ischaemic Stroke) is a multicentre, prospective, double-blinded, randomised trial enrolling 1360 patients in China. Eligible patients will be randomised 1:1 to either the tirofiban or placebo group. Outcome The primary efficacy outcome is assessed as the proportion of participants with a modified Rankin Scale score of 0–2 at 90 days, and the primary safety outcome is symptomatic intracranial haemorrhage within 48 hours from randomisation. Conclusions This study will provide evidence on the efficacy and safety of sequential tirofiban therapy after successful recanalisation in patients with anterior circulation LVO stroke. Trial registration number NCT06265051 .