Original Article
Efficacy of different vascular recanalization methods for acute ischemic stroke
Yuhui Chen, Lei Xu, Peng Qi, Jun Lu, Juan Chen, Tao Gong
Published 2019-07-04
Cite as Chin J Gen Pract, 2019, 18(7): 657-662. DOI: 10.3760/cma.j.issn.1671-7368.2019.07.009
Abstract
ObjectiveTo assess the efficacy of different vascular recanalization methods for acute ischemic stroke (AIS).
MethodsThe clinical data of AIS patients receiving vascular recanalization therapy in Beijing Hospital from January 2010 to July 2018 were retrospectively analyzed. Among 141 AIS patients, 64 received intravenous thrombolysis (IVT group), 57 received endovascular treatment (EVT group) and 20 received intravenous thrombolysis and endovascular treatment (IVT+EVT group). The efficacy and safety of therapy were compared among three groups.
ResultsThere were no significant differences in the risk factors of cerebrovascular diseases among 3 groups (P>0.05). The National Institute of Health Stroke Scale (NIHSS) scores [M(Q1, Q3)] of patients in the IVT group, EVT group and IVT+EVT group were 9.5 (6.0, 15.0), 15.0 (9.0, 19.0) and 14.0(8.3, 17.0), respectively (Z=7.19, P<0.05). The time from onset to treatment in the three groups was 205.0 (156.3, 254.3) min, 260.0 (170.0, 401.5) min, and 137.5 (90.3, 137.5) min, respectively (Z=22.83, P<0.01). The proportion of large arteries occlusion was lower in IVT group (32.8%, 21/64), compared with EVT group (86.0%, 49/57) and IVT+EVT group (95.0%, 19/20) (χ2=46.77, P<0.01). The proportion of symptomatic intracranial hemorrhage in IVT group was lower than EVT and IVT+EVT group [1.6% (1/64) vs. 15.8% (9/57) and 10.0% (2/20), χ2=8.36, P<0.05]. The favorable outcome rates in IVT, EVT and IVT+EVT groups at the 90 d (mRS score≤2) were 57.8% (37/64), 45.6% (26/57) and 40.0% (8/20) , respectively (χ2=2.79, P=0.24). The fatality rates in three groups were 10.9% (7/64), 19.3% (11/57) and 5.0% (1/20), respectively (χ2=2.84, P=0.21).
ConclusionsIntravenous thrombolysis, endovascular therapy and bridging therapy have similar effects on the prognosis of AIS. Mild severity of AIS patients are more likely to benefit from intravenous thrombolysis. AIS patients with severe disease are usually combined with large artery occlusion, and more suitable for endovascular treatment and bridging treatment.
Key words:
Acute disease; Brain infarction; Intravenous thrombolysis; Mechanical thrombolysis
Contributor Information
Yuhui Chen
Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Lei Xu
Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Peng Qi
Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Jun Lu
Department of Neurosurgery, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Juan Chen
Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Tao Gong
Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
