Intra-Arterial Thrombolysis and Stenting for Acute Basilar Artery Occlusion
- VernacularTitle:动脉溶栓和支架置入术治疗急性基底动脉闭塞
- Author:
Yaoyu YU
;
Guodong GAO
;
Zhenwei ZHAO
;
Youzhi QU
;
Jianping DENG
;
Derang JIAO
;
Bingge CHANG
;
Jinqing YANG
;
Lizhong CHEN
- Publication Type:Journal Article
- Keywords:
basilar artery occlusion;
intra-arterial thrombolysis;
stenting
- From:
International Journal of Cerebrovascular Diseases
2008;16(6):447-451
- CountryChina
- Language:Chinese
-
Abstract:
Objectire:To explore and evaluate the predictors for the prognosis of acute besilar artery occlusion(BAO)and the clinical efficacy of intra-arterial thrombolysis and stenting for BAO.Methods:Intra-arterial thrombolysis was administered with recombinant tissue plasminogen activator or urokinase in 52 patients with BAO within 3 to 48 hours.Stenting was performed in patients whose partial recanalization of residual stenosis>50%after the thrombolysis.National Institutes of Health Stroke Scale(NIHSS)score was measured before the procedure,and the modifled Rankin scale(mRS)score was obtained at 3 months after the procedure.The clinical data were evaluated with the multivariable stepwise logistic regression analysis and Fisher's exact test.Results:Complete recanalization achieved in 24 patients(46.2%),partial recanalization in 16 patients(30.7%),and non-recanalization in 12 patients(23.1%).mRS scores:22 patients(42.3%)had a favorable outcome,32 survived(61.5%),and 20 died (38.5%).The prognosis of BAO was significantly correlated with the NIHSS score(P<0.01),therapeutic time window (P <0.05) and recanalization level (after the thrombolysis and stenting)(P<0.01 );the good recanalization after the intra-arterial thrombolysis was significantly correlated with the NIHSS score (P <0.01) and therapeutic time window (P <0.05).Multivariate analysis showed that the NIHSS score < 14 (P < 0.01 ) and good recanalization could independently predict the favorable prognosis of BAO.Conclusions:The NIHSS score < 14 and good recanalization were the independent predictors for good prognosis of BAO.The rapid and timely treatment of BAO with intra-arterial thrombolysis and stenting is a safe and effective measure.