Clinical observation of emergency endovascular recanalization therapies for acute ischemic stroke

doi:10.3877/cma.j.issn.2095-5782.2014.02.002

Abstract

Abstract:

Objective

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

Methods

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.

Results

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).

Conclusions

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.

Key words: Stroke, Thrombolysis, Balloon, Stents, Mechanical recanalization

Zibo Wang, Sheng Guan, Xinbin Guo, Haowen Xu, Chao Liu, Dongdong Li. Clinical observation of emergency endovascular recanalization therapies for acute ischemic stroke[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2014, 02(02): 4-9.

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Figures/Tables 5

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资料	完全再通	部分再通	未通
年龄（岁）	55.4±13.9	64.8±7.3	53.8±15.7
发病时间（h）	7.5±3.60	6.0±2.1	7.6±2.7
术前NIHSS（分）	20.1±5.0	18.6±4.8	20.8±5.0
术后1天NIHSS（分）	13.3±10.9	14.8±10.6	20.9±7.2
术后3个月NIHSS（分）	10.3±12.8	16.0±13.2	22.8±8.6

资料	完全再通	部分再通	未通
年龄（岁）	55.4±13.9	64.8±7.3	53.8±15.7
发病时间（h）	7.5±3.60	6.0±2.1	7.6±2.7
术前NIHSS（分）	20.1±5.0	18.6±4.8	20.8±5.0
术后1天NIHSS（分）	13.3±10.9	14.8±10.6	20.9±7.2
术后3个月NIHSS（分）	10.3±12.8	16.0±13.2	22.8±8.6

预后	例数	完全再通	部分再通	未通
良好	16	15	1	0
不良	9	3	2	4
死亡	9	1	2	3

预后	例数	完全再通	部分再通	未通
良好	16	15	1	0
不良	9	3	2	4
死亡	9	1	2	3

预后	例数	有代偿	无代偿
良好	14	11（57.89）	3（25.0）
不良	9	6（31.58）	3（25.0）
死亡	8	2（10.53）	6（50.0）

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