Comparative study of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large-artery occlusive stroke
10.3760/cma.j.issn.1671-8925.2020.02.005
- VernacularTitle:急性前循环大血管闭塞性脑卒中直接机械取栓与桥接治疗的对照研究
- Author:
Haibing REN
1
;
Huiqin LIU
;
Sisi WANG
;
Jianying ZHANG
;
Wenjin YANG
;
Xiaohui ZHAO
;
Ke QING
;
Guodong XIAO
;
Yongjun CAO
Author Information
1. 上海市浦东新区人民医院神经内科 201299
- Keywords:
Ischemic stroke;
Anterior circulation;
Mechanical thrombectomy;
Intravenous thrombolysis;
Bridging therapy
- From:
Chinese Journal of Neuromedicine
2020;19(2):131-137
- CountryChina
- Language:Chinese
-
Abstract:
Objective To comparatively analyze the safety and efficacy of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke.Methods A total of 116 patients with acute anterior circulation large-artery occlusive stroke,admitted to our hospitals from October 2015 to March 2018,were chosen in our study;their clinical data were analyzed retrospectively.Among them,63 patients accepted direct mechanical thrombectomy and 53 accepted bridging therapy.The preoperative baseline data and the diagnoses and treatments of the two groups were analyzed;the degrees of modified thrombolysis in cerebral infarction (mTICI),incidences of hemorrhage transformation and symptomatic intracranial hemorrhage,and modified Rankin scale (mRS) scores and mortality rate 90 d after operation were compared between the two groups.Results The preoperative Alberta stroke program early CT scale (ASPECTS) and Glasgow Coma Scale (GCS) scores of the direct mechanical thrombectomy group were significantly lower than those of the bridge therapy group (P＜0.05),and the time from onset to admission was significantly longer than that of the bridging therapy group (P＜0.05).The incidence of postoperative hemorrhage transformation in the direct mechanical thrombectomy group was significantly higher than that in the bridging therapy group (34.9％ vs.17.0％,P＜0.05),but there were no significant differences in the effective recanalization rate (69.8％ vs.79.3％),intracranial symptomatic hemorrhage rate (15.9％ vs.7.6％),favorable outcome rate (28.6％ vs.35.9％) and mortality (22.2％ vs.17.0％) between the two groups (P＞0.05).Conclusion The clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for patients with acute anterior circulation large-artery occlusive stroke are similar.
