Study on effect application of venous urokinase thrombolysis combined with stent-thrombectomy in treating patients with acute anterior circulation of cerebral infarction
Author(s): WU Ying-chun, WANG Jun-mei, WANG Zhe, SUN Rui, HAO Xiao-jun, FENG Guan-qing
Pages: 497-502
Year: 2017 Issue: 8
Journal: Journal of Brain and Nervous Diseases
Keyword: Cerebral infarction; Anterior circulation; Thrombectomy; Solitaire AB; Urokinase; Venous thrombolysis;
Abstract: Objective To investigate the effect of venous urokinase thrombolysis combined with mechanical thrombectomy device Solitaire AB for the treatment of occlusion of intracranial artery caused acute anterior circulation of cerebral infarction. Method Between October 2015 and April 2016,a total of 8 patients with acute cerebral infarction(ACI)underwent thrombectomy by using Solitaire AB stent at Ordos Central Hospital. Simple middle cerebral artery occlusion was seen in 4,2 of them was accompanied with proximal internal carotid artery occlusion. 2 of them had terminal internal carotid artery occlusion. The clinical features, imaging data, treatment and the results of 3 month clinical follow up were analyzed. The effectiveness of treatment was evaluated through the recanalization rate after stent thrombectomy, the National Institutes of Health Stroke Scale Scores(NIHSS)before and after treatment, the modified Rankin scale(mRs)scores, and the 3 month clinical follow up results. The surgery related complications and mortality of patients were used to evaluate the safety of the treatment. Results All of the 8 patients treated by venous urokinase thrombolysis combined with mechanical thrombectomy device Solitaire AB were recanalized successfully. The modified throbolysis in cerebral infarction(mTICI)was 2b or 3. The NIHSS score median 6(0,12)at discharge dropped significantly compared with 16.5(12,24)before procedure(P<0.05). No permanent complications related to operation occurred. 6 patients had good prognosis(mRs0-2).One of the recanalized patients had disability(mRs3-4)and the other was died in large area cerebral infarction.Conclusion For the treatment of acute MCA and TIM occlusion,venous urokinase thrombolysis combined with Solitaire AB stent thrombectomy can get higher vascular recanalization rate and clinically safe with satisfactory clinical outcome,although Solitaire AB stent thrombectomy for terminal internal carotid artery occlusion is not satisfactory clinical as its mortality is higher.
Pages: 497-502
Year: 2017 Issue: 8
Journal: Journal of Brain and Nervous Diseases
Keyword: Cerebral infarction; Anterior circulation; Thrombectomy; Solitaire AB; Urokinase; Venous thrombolysis;
Abstract: Objective To investigate the effect of venous urokinase thrombolysis combined with mechanical thrombectomy device Solitaire AB for the treatment of occlusion of intracranial artery caused acute anterior circulation of cerebral infarction. Method Between October 2015 and April 2016,a total of 8 patients with acute cerebral infarction(ACI)underwent thrombectomy by using Solitaire AB stent at Ordos Central Hospital. Simple middle cerebral artery occlusion was seen in 4,2 of them was accompanied with proximal internal carotid artery occlusion. 2 of them had terminal internal carotid artery occlusion. The clinical features, imaging data, treatment and the results of 3 month clinical follow up were analyzed. The effectiveness of treatment was evaluated through the recanalization rate after stent thrombectomy, the National Institutes of Health Stroke Scale Scores(NIHSS)before and after treatment, the modified Rankin scale(mRs)scores, and the 3 month clinical follow up results. The surgery related complications and mortality of patients were used to evaluate the safety of the treatment. Results All of the 8 patients treated by venous urokinase thrombolysis combined with mechanical thrombectomy device Solitaire AB were recanalized successfully. The modified throbolysis in cerebral infarction(mTICI)was 2b or 3. The NIHSS score median 6(0,12)at discharge dropped significantly compared with 16.5(12,24)before procedure(P<0.05). No permanent complications related to operation occurred. 6 patients had good prognosis(mRs0-2).One of the recanalized patients had disability(mRs3-4)and the other was died in large area cerebral infarction.Conclusion For the treatment of acute MCA and TIM occlusion,venous urokinase thrombolysis combined with Solitaire AB stent thrombectomy can get higher vascular recanalization rate and clinically safe with satisfactory clinical outcome,although Solitaire AB stent thrombectomy for terminal internal carotid artery occlusion is not satisfactory clinical as its mortality is higher.
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