Effect of stent-assisted thrombectomy combined with intermediate catheter aspiration in the treatment of acute basilar artery occlusive cerebral infarction
10.7683/xxyxyxb.2024.06.007
- VernacularTitle:支架联合中间导管取栓治疗急性基底动脉闭塞性脑梗死疗效观察
- Author:
Jian DING
1
;
Ruinan SONG
;
Hailiang WANG
;
Jie LIU
;
Erping CUI
Author Information
1. 沧州市人民医院神经内科,河北 沧州 061000
- Keywords:
acute basilar artery occlusive cerebral infarction;
stent-assisted thrombectomy;
stent-assisted thrombectomy combined with intermediate catheter aspiration
- From:
Journal of Xinxiang Medical College
2024;41(6):538-542
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical efficacy of stent-assisted thrombectomy combined with intermediate catheter aspiration in the treatment of acute basilar artery occlusive cerebral infarction.Methods Eighty patients with acute basilar artery occlusive cerebral infarction admitted to the Department of Neurology of Cangzhou People's Hospital from July 2022 to July 2023 were selected as the research subjects.The patients were divided into the control group(stent-assisted thrombectomy)and the observation group(stent-assisted thrombectomy combined with intermediate catheter aspiration)according to the treatment method,with 40 patients in each group.The neurological deficit of the patients in both groups was evaluated by using the National Institutes of Health Stroke Scale(NIHSS)before and after the intervention;the vascular recanalization of the patients was evaluated by using the modified thrombolysis in cerebral infarction(mTICI)grade;and the clinical prognosis of the patients was assessed by using the modified Rankin scale(mRS)at 3 months after treatment(mRS score ≤2:favorable prognosis;mRS score＞2:poor prognosis).A 12-month postoperative follow-up was conducted to monitor the incidence of complications and the mortality rate.Results There was no significant difference in the NIHSS score of patients between the two groups before treatment(P＞0.05);the NIHSS scores of patients in both groups at 24 hours and 3 months after treatment were significantly lower than those before treatment(P＜0.01);the NIHSS scores of patients in the observation group at 24 hours and 3 months after treatment were significantly lower than those in the control group(P＜0.01).There were a total of 22 patients with mTICI grades of 2b and 3 in the control group,and the first vascular recanalization rate was 55.0％(22/40);there were a total of 35 patients with mTICI grades of 2b and 3 in the observation group,and the first vascular recanalization rate was 87.5％(35/40);and the first vascular recanalization rate of patients in the observation group was significantly higher than that in the control group(x2=0.375,P＞0.05).Three months after treatment,there were 13 patients in the control group with an mRS score of 0 to 2,and the favorable prognosis rate was 32.5％(13/40);there were 21 patients in the observation group with an mRS score of 0 to 2,and the favorable prognosis rate was 52.5％(21/40);the favorable prognosis rate of patients in the observation group was significantly higher than that in the control group(x2=6.619,P＜0.05).During the 12-month follow-up,stroke-associated pneumonia occurred in 18 patients(45.0％),cerebral hernia occurred in 5 patients(12.5％),symptomatic intracranial hemorrhage occurred in 4 patients(10.0％),and 12 patients died,with a fatality rate of 30.0％in the control group;while in the observation group,stroke-associated pneumonia occurred in 10 patients(25.0％),cerebral hernia occurred in 4 patients(10.0％),symptomatic intracranial hemorrhage hemorrhage occurred in 2 patients(5.0％),and 8 patients died,with a fatality rate of 12.0％.There was no significant difference in the incidence of cerebral hernia and symptomatic intracranial hemorrhage between the observation group and control group(x2=0.125,0.721;P＞0.05).The incidence of stroke-associated pneumonia and the fatality rate of patients in the observation group were significantly lower than those in the control group(x2=4.016,3.954;P＜0.05).Conclusion Stent-assisted thrombectomy combined with intermediate catheter aspiration can effectively improve the first recanalization rate and enhance the neurological function and prognosis of patients with acute basilar artery occlusive cerebral infarction.
