Efficacy and safety of arterial thrombolysis in patients with wake-up ischemic stroke of anterior circulation non-major arteries
10.3760/cma.j.cn115354-20230309-00134
- VernacularTitle:前循环非大动脉醒后缺血性脑卒中动脉溶栓的疗效及安全性研究
- Author:
Junying SHANG
1
;
Weihua JIA
;
Yisen ZHANG
;
Lei LIU
;
Xifang SONG
;
Jiayang LI
Author Information
1. 首都医科大学石景山教学医院，北京市石景山医院神经内科，北京 100043
- Keywords:
Wake-up ischemic stroke;
Anterior circulation;
Non-major artery;
Recombinant tissue plasminogen activator;
Arterial thrombolysis
- From:
Chinese Journal of Neuromedicine
2023;22(7):666-672
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of recombinant tissue plasminogen activator (rt-PA) in patients with wake-up ischemic stroke (WUIS) of anterior circulation non-major arteries.Methods:Sixty-seven patients with WUIS of anterior circulation non-major arteries (time from falling asleep/last use of bathroom at night to intravenous thrombolysis≤9 h and >4.5 h) admitted to Department of Neurology, Beijing Shijingshan Hospital and Department of Neurosurgery, Beijing Muyangliu Hospital from January 1 st, 2017 to December 31 st, 2021 were chosen; these 35 patients accepted routine antiplatelet therapy after intravenous thrombolytic therapy were chosen as control group, and the other 32 patients accepted rt-PA arterial thrombolysis after intravenous thrombolytic therapy were chosen as study group. Vascular recanalization after arterial thrombolysis was observed in study group (cerebral infarction thrombolysis grading 2 and 3: good vascular recanalization). Neurological deficit improvement during treatment, clinical prognoses (modified Rankin scale scores of 0-2: good prognosis) and hemorrhagic transformation incidence 3 months after treatment were compared between the 2 groups. Results:The vascular thrombolytic recanalization rate of study group was 81.25% (26/32). Patients in study group had significantly decreased National Institute of Health stroke scale scores compared with those in control group 1, 7, and 14 d after thrombolytic therapy ( P<0.05). The good prognosis rate of study group (62.50%, 20/32) was significantly higher than that in control group (37.14%, 13/35, P<0.05). No significant difference in hemorrhagic transformation rate was noted between the 2 groups (15.6% [5/32] vs. 5.71% [2/35], P>0.05). Conclusion:Patients with WUIS of anterior circulation non-major arteries (time from falling asleep/last use of bathroom at night to intravenous thrombolysis≤9 h and >4.5 h) benefit from arterial thrombolysis with rt-PA, and risk of secondary intracerebral hemorrhage is not obviously increased.
