科研之友
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摘要
Background: Both intra-arterial recombinant tissue plasminogen activator (rt-PA) and stent retrieval are effective for treating acute ischemic stroke. The goal of this study was to evaluate the effectiveness of stent retrieval combined with intra-arterial rt-PA administration via micro-catheter (called the complex technique) in acute ischemic stroke. Material and methods: A retrospective analysis was performed of 93 consecutive patients treated between 2015 and 2017 for occlusions of the intracranial large artery using the complex technique (n = 37) or stent retrieval alone (n = 56) in our stroke center. Data on procedure duration, number of passes, and angiographic findings were collected. Successful recanalization was defined as the accomplishment of grade 3 or 2b modified Treatment in Cerebral Ischemia recanalization in 1 or 2 passes. Results: Compared to the stent retrieval group, complex technique group had a higher successful revascularization rate with 1 or 2 passes with the stent retriever (81.1% versus 51.8%, P = 0.004), a shorter procedure time (59 +/- 34 min versus 94 +/- 56 min, P < 0.001), fewer passes of the stent retriever (1.8 +/- 1.1 versus 2.5 +/- 1.4, P = 0.012), a better prognosis (70.3% versus 48.2%, P = 0.035), a lower embolic complication rate (18.9% versus 39.3%, P = 0.038), similar mortality (13.5% versus 21.4%, P = 0.334) and similar intracranial hemorrhage symptoms (2.7% versus 12.5%, P = 0.204). Intra-arterial rt-PA administration was an independent negative predictor of procedure time (OR = -0.292, P = 0.003). Conclusion: Mechanical thrombectomy utilizing stent retrieval combined with intra-arterial rt-PA administration in the anterior circulation of acute ischemic stroke patients improved the angiographic results and shortened the procedure duration without increasing adverse events.
- 出版日期2018-3-15
- 单位福建医科大学
