Efficacy and safety of vascular intervention combined with intravenous thrombolysis in treatment of acute intracranial arterial occlusion

Abstract

Efficacy and safety of vascular intervention combined with intravenous thrombolysis (IVT) was investigated in the treatment of acute intracranial arterial occlusion (AIAO). Ninety-two patients with AIAO treated in People's Hospital of Tongchuan from January 2014 to February 2016 were enrolled in this retrospective study. Forty-two patients were treated with vascular intervention (control group), while another 50 patients were treated with vascular intervention combined with IVT (study group). They were observed in terms of the improvement of clinical efficacy after treatment, the comparison of complications after treatment, the National Institute of Health Stroke Scale (NIHSS) score after treatment, the modified Rankin Scale (mRS) score at 3 months after treatment, and the Mini-Mental State Examination (MMSE) score at 3 months after treatment. Compared with those in the control group, patients in the study group had statistically significantly higher marked effectiveness and statistically significantly lower ineffectiveness (P= 0.018), and a statistically significantly higher overall effective rate (P=0.042). The NIHSS score in the study group was statistically significantly lower than that in the control group after treatment (P=0.001). There was a statistically significant difference between the two groups in the mRS score at 3 months after treatment (Z=8.764, P>0.05). Compared with those in the control group, patients in the study group had a statistically significantly higher MMSE score after treatment, and a statistically significantly lower total incidence of postoperative complications (P=0.001). Vascular intervention combined with IVT has good efficacy and high safety in the treatment of AIAO, and the combination can statistically significantly improve patients' quality of life, so it has a good clinical application value.

Effect of intravenous thrombolysis combined with endovascular treatment on vascular recanalization rate and peak systolic velocity in patients with acute cerebral infarction

“…In the present study, mRS was used to assess the neurological function recovery of the patients and we found that the mRS scores were lower in patients received the IVT+EVT approach, which is consistent with the findings by Huo et al 8 and Zhu et al 12 . In addition, our findings on the incidence of MACE after treatment support the study by Yang et al 21 that there was no significant difference in incidence rate of MACE in patients received EVT alone or IVT+EVT.…”

“… 7 - 9 , 17 - 20 Some studies have found that patients with ACI who received IVT+EVT had better recanalization rates. 8 , 12 , 17 , 20 A shorter time from symptom onset to recanalization was associated with better clinical outcomes and neurological function in patients with ACI. 12 Further evidence shows that EVT following IVT may improve the vascular recanalization rate, subsequently improving survival and recovery in patients with acute ischemic stroke.…”

“…onset to recanalization was associated with better clinical outcomes and neurological function in patients with ACI. 12 Further evidence shows that EVT following IVT may improve the vascular recanalization rate, subsequently improving survival and recovery in patients with acute ischemic stroke. 20 However, application of IVT+EVT may lead to higher hospital costs without improving the vascular recanalization or functional outcomes.…”

“…[7][8][9][17][18][19][20] Some studies have found that patients with ACI who received IVT+EVT had better recanalization rates. 8,12,17,20 A shorter time from symptom Compared within the same group before treatment, *P < 0.001.…”

“…The specific surgical procedures have been detailed in previous published literature. 12 After the operation, the patient was monitored for 24 hours by electrocardiogram. Patients in both groups underwent CT examination 24 hours after IVT.…”