Objective Herein, we evaluated the efficacy and safety of intra-arterial mild hypothermia in combination with arterial thrombolysis to treat acute cerebral infarction due to middle cerebral artery occlusion.MethodsA total of 26 patients with acute middle cerebral artery occlusion were divided into a normothermia group (n = 15) and a mild hypothermia group (n = 11). The infarct volumes at 24 h and 7 days after the operation were compared between the normothermia group and the mild hypothermia group. Additionally, we compared neurological deficit scores between the two groups at 24 h, 7 days, and 1 mo after the operation.ResultsThe infarct volumes and neurological deficit scores of the mild hypothermia group were significantly reduced compared to those in the normothermia group (p < 0.05). Furthermore, no adverse reactions or complications occurred in the mild hypothermia group.ConclusionIntra-arterial mild hypothermia reduced infarct volume after ischemia–reperfusion injury in the arterial thrombolysis of an acute cerebral infarction. Additionally, it improved the prognosis of patients with an acute middle cerebral artery occlusion, suggesting that this procedure is safe and effective for treating acute cerebral infarction.
ObjectiveTo assess the safety and efficacy of stent thrombectomy alone or combined with intermediate catheter aspiration for severe cerebral venous sinus thrombosis.MethodWe retrospectively collected the clinical data of 7 patients with severe CVST who received endovascular treatment at our hospital from January 2017 to June 2020. The patients had at least one adverse prognostic factor (mental status disorder, comatose state, intracerebral hemorrhage, or thrombosis of the deep venous system).ResultsThe median age was 51 years. Three patients were women. Two or more venous sinuses were in involved in 5 patients. All patients received systemic anticoagulant therapy before endovascular therapy. Neurological deterioration was the main reason for patients with cerebral venous sinus thrombosis undergoing intravascular therapy. The median time from admission to intravascular therapy was 3 days (1–9 days). Primary endpoints: 6 patients (85.7%) had a modified Rankin scale score of 0 at day 90, and 1 patient (14.3%) had a modified Rankin scale score of 2 at day 90. Secondary endpoints: complete recanalization was achieved in 4 cases (57.1%) and partial recanalization in 3 cases (42.9%).ConclusionStent thrombectomy, combined with intermediate catheter aspiration, balloon dilation, and regional thrombolysis/anticoagulation treatment, is an effective strategy to treat severe cerebral venous sinus thrombosis patients who had inadequate response to anticoagulant therapy. This strategy can quickly eliminate the occluded venous sinus and improve prognosis of severe cerebral venous sinus thrombosis.
BackgroundNeutrophil-to-lymphocyte ratio (NLR) has been shown to be an important inflammatory maker. This study aims to investigate the association of NLR with intracranial and extracranial atherosclerotic stenosis.MethodsWe retrospectively recruited patients who underwent digital subtraction angiography (DSA) for evaluating intracranial/extracranial stenosis in the Zhongnan Hospital of Wuhan University from January 2017 to October 2021. Clinical characteristics, DSA data, blood routine, and lipid profile were recorded. Logistic regression was used to evaluate the association of NLR and intercranial/extracranial atherosclerotic stenosis in three aspects: distribution of stenosis, whether the stenosis is symptomatic, and degree of stenosis.ResultsA total of 1,129 patients were included in our analysis, with a median age of 62 y (interquartile range 55–68), and a median admission NLR of 2.39 (interquartile range 1.84–3.42). A total of 986 patients presented intracranial and/or extracranial atherosclerotic stenosis. Increased NLR were associated with intracranial stenosis [odds ratio (OR), 1.54; 95% CI, 1.27–1.85; p < 0.001], extracranial stenosis (OR, 1.56; 95% CI, 1.25–1.96; p < 0.001), and combined intracranial/extracranial stenosis (OR, 1.61; 95% CI, 1.28–2.03; p < 0.001). After adjustment of potential factors, higher NLR were independently associated with symptomatic stenosis (OR, 1.16; 95% CI, 1.05–1.27; p = 0.003) and degree of stenosis (OR, 1.32; 95% CI, 1.17–1.49; p < 0.001). Compared with the first quartile NLR, the second, third, and fourth quartiles NLR were independent risk factors for symptomatic stenosis and stenosis degree (both p for trend <0.001).ConclusionIncreased NLR is an important factor associated with both intracranial and extracranial atherosclerotic stenosis. Patients with symptomatic intracranial/extracranial atherosclerotic stenosis or a more severe degree of stenosis presented elevated NLR levels.
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