Objective:To observe the clinical efficacy of rt-PA in the treatment of patients with acute ischemic stroke ( CIS) and hyperdense middle cerebral artery sign ( HMCAS) . Methods:Totally 107 patients with CIS and HMCAS were randomly divided into the control group (n=54) and the treatment group (n=53). The control group was treated with urokinase, while the treatment group was treated with recombinant tissue type plasminogen activator ( rt-PA) . The treatment course was 14 days, and then the clinical effi-cacy and safety were evaluated. Results:Compared with that before the treatment, the score of national institute of health stroke scale ( NIHSS) in both groups was decreased after the treatment, and the decrease in the treatment group was more notable than that in the control group with statistically significant difference (P<0. 05). The clinical effective rate of the treatment group was 88. 68%, while that of the control group was 79. 63%, and there was statistically significant difference between the groups (P<0. 05). Compared with that before the treatment, BI index in both groups was increased after the treatment, and the increase in the treatment group was more significant than that in the control group with statistically significant difference (P<0. 05). Conclusion:rt-PA thrombolytic therapy in the patients with CIS and HMCAS has remarkable clinical efficacy, which can improve patients’ life quality and is worthy of promo-tion.

Objective:To compare the effect of anesthesia mode on the neurological functional outcomes in patients undergoing endovascular treatment for acute posterior circulation ischemic stroke.Methods:Clinical data of 656 patients undergoing intravascular therapy for acute posterior circulation ischemic stroke registered in online Acute Stroke Patients for Stroke Management Quality Evaluation Database from January 2017 to December 2022 were retrospectively analyzed.The data included 163 cases with conscious sedation and 493 cases with general anesthesia during the procedure.After propensity score matching,428 patients were included in the analysis,including 155 cases in the conscious sedation group and 273 cases in the general anesthesia group.The differences of operation mode,etiology type,vascular recanalization,hemorrhagic transformation at 24 h,modified Rankin Scale(mRS)score at 3 months and mortality within 3 months were compared between the two groups.Binary logistic regression was used to explore the effect of different anesthesia mode on neurological functional outcomes.Results:There was a significant difference in operation mode between the two groups(P<0.01),while there were no significant differences in etiology type,vascular recanalization,hemorrhagic transformation at 24 h,mRS score at 3 months or mortality within 3 months(all P>0.05).Binary logistic regression analysis revealed that anesthesia modes were not significantly associated with functional outcomes of patients(OR=1.151,95%CI:0.751-1.765,P>0.05).Conclusion:Anesthesia mode(conscious sedation or general anesthesia)will not affect the neurological functional outcomes in patients with acute posterior circulation ischemic stroke undergoing endovascular treatment.