Interventional treatment for acute occlusive stroke caused by anterior circulation intracranial atherosclerotic stenosis:an efficacy and safety assessment
10.3969/j.issn.1004-1648.2025.05.007
- VernacularTitle:前循环颅内动脉粥样硬化性狭窄所致急性大血管闭塞性缺血性脑卒中的介入治疗:一项疗效与安全性评估
- Author:
Yiping LI
1
;
Lan JIANG
;
Mengfei SUN
Author Information
1. 221000 徐州医科大学徐州临床学院
- Publication Type:Journal Article
- Keywords:
intracranial atherosclerotic stenosis;
mechanical thrombectomy;
balloon dilation angioplasty;
stenting
- From:
Journal of Clinical Neurology
2025;38(5):349-355
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the application selection and clinical effects of different vascular recanalization techniques in acute ischemic stroke with large artery occlusion(AIS-LVO)induced by anterior circulation intracranial atherosclerotic stenosis(ICAS).Methods Retrospectively,156 AIS-LVO patients caused by anterior circulation ICAS,who were admitted to Xuzhou Central Hospital from January 2022 to September 2024,were included.The patients were divided into three groups according to the surgical methods.The baseline data,endovascular treatment related data,postoperative efficacy and safety indicators of patients were analyzed statistically.The influencing factors of prognosis were analyzed usinga multi-factor Logistic regression model.Results The final enrollment result was 70 patients in thrombectomy-only group,48 patients in thrombectomy combined with balloon dilation group,and 38 patients in thrombectomy combined with stenting group.There was a statistically significant difference in the proportion of hyperlipidemia among the three groups before treatment(P＜0.05).However,further analysis revealed that there was no difference between any two groups.The time from puncture to recanalization in the thrombectomy-only group was significantly lower than that in the other two groups(all P＜0.05).After treatment,the restenosis rate in the thrombectomy combined with stenting group was significantly lower than the other two groups,while the intracerebral hemorrhage rate was significantly higher(all P＜0.05).Multivariate Logistic regression analysis showed that the NIHSS score at admission was an independent risk factor for prognosis(OR=2.780,95％CI:1.212-6.374,P=0.016).Conclusion For AIS-LVO induced by anterior circulation ICAS,salvage balloon dilation or stenting after thrombectomy alone is safe and effective,resulting in a good prognosis for most patients and a reduced rate of restenosis.
