To explore the efficacy, safety and individuation of emergency endovascular recanalization in treatment of acute ischemic stroke (AIS).

The clinical d ata of 31 patients with AIS and DSA showed main trunk occlusion, who underwent emergency intervention operation were retrospectively analyzed, to evaluate the technical success rate, efficacy and the risk.

Among 31 patients, 24 cases were recanalized successfully, technical success rate was 77.42% (24/31), including 19 cases achieved immediate postoperative blood vessel recanalization (TICI grade 3), 5 cases partial recanalization (TICI grade 2). In the 24 recanalized patients, 8 cases underwent superselective intra-arterial contact thrombolysis, 16 cases underwent mechanical endovascular recanalization therapies including balloon mechanical expanding, self-expanding type stent implantation or solitaire stent clot-retrieval. Among 31 patients, 7 cases (7/31, 22.58%) died and 2 of them were died of intracranial hemorrhage (2/31, 6.45%), each occurred within 12 h after thrombolysis and thrombectomy, 5 cases died of large infarction (5/31, 16.13%), including 2 cases of acute thrombus recurrent and 3 cases failed to recanalize and infarction symptoms aggravated. In the 90 days’ follow-up, the discharge patients who had good prognosis (MRS≤2) accounted for 51.61% (16/31), for these patients, complete recanalizationrate was 78.95% (15/19), with lateral branch compensatory verified by preoperative DSA was 57.89% (11/19).

Emergency endovascular recanalization for AIS is feasible, effective and safer. It has the potential to be the first choice for cases with main trunk occlusion.

Stroke; Thrombolysis; Balloon; Stents; Mechanical recanalization