Endovascular Intervention
Comparative study of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large-artery occlusive stroke
Ren Haibing, Liu Huiqin, Wang Sisi, Zhang Jianying, Yang Wenjin, Zhao Xiaohui, Qing Ke, Xiao Guodong, Cao Yongjun
Published 2020-02-15
Cite as Chin J Neuromed, 2020,19(02): 131-137. DOI: 10.3760/cma.j.issn.1671-8925.2020.02.005
Abstract
ObjectiveTo comparatively analyze the safety and efficacy of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke.
MethodsA total of 116 patients with acute anterior circulation large-artery occlusive stroke, admitted to our hospitals from October 2015 to March 2018, were chosen in our study; their clinical data were analyzed retrospectively. Among them, 63 patients accepted direct mechanical thrombectomy and 53 accepted bridging therapy. The preoperative baseline data and the diagnoses and treatments of the two groups were analyzed; the degrees of modified thrombolysis in cerebral infarction (mTICI), incidences of hemorrhage transformation and symptomatic intracranial hemorrhage, and modified Rankin scale (mRS) scores and mortality rate 90 d after operation were compared between the two groups.
ResultsThe preoperative Alberta stroke program early CT scale (ASPECTS) and Glasgow Coma Scale (GCS) scores of the direct mechanical thrombectomy group were significantly lower than those of the bridge therapy group (P<0.05), and the time from onset to admission was significantly longer than that of the bridging therapy group (P<0.05). The incidence of postoperative hemorrhage transformation in the direct mechanical thrombectomy group was significantly higher than that in the bridging therapy group (34.9% vs. 17.0%, P<0.05), but there were no significant differences in the effective recanalization rate (69.8% vs. 79.3%), intracranial symptomatic hemorrhage rate (15.9% vs. 7.6%), favorable outcome rate (28.6% vs. 35.9%) and mortality (22.2% vs. 17.0%) between the two groups (P>0.05).
ConclusionThe clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke are similar.
Key words:
Ischemic stroke; Anterior circulation; Mechanical thrombectomy; Intravenous thrombolysis; Bridging therapy
Contributor Information
Ren Haibing
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Liu Huiqin
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Wang Sisi
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Zhang Jianying
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Yang Wenjin
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Zhao Xiaohui
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Qing Ke
Department of Neurology, Pudong New Area People's Hospital, Shanghai 201299, China
Xiao Guodong
Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
Cao Yongjun
Department of Neurology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China
