Clinical treatment efficiency of mechanical thrombectomy combined with rhPro-UK thrombolysis for acute moderate/severe cerebral infarction.

Abstract

This study aims to compare clinical efficiency of mechanical thrombectomy combined with rhPro-UK thrombolysis on moderate or severe acute brain infarction. A total of 90 acute cerebral infarction patients due to artery stenosis or blockade from May 2016 to May 2017 were recruited and randomly assigned into thrombolysis group (N = 30), mechanical thrombectomy (N = 30), and combined treatment group (N = 30). Clinical information was collected. Thrombolysis group received rhPro-UK, mechanical thrombectomy group received Solitaire scaffold, and combined group received rhPro-UK after Solitaire scaffold. Barthel scale and NIHSS scale were used to evaluate the quality of life and mental deficit of patients. Modified thrombolysis in cerebral infarction (mTICI) was compared among three groups, along with the observation of hemorrhage, neurological recovery within 90 days, and adverse effects. No significant difference was found in NIHSS within 24 h of treatment among three groups (p > 0.05), but the decreasing levels were shown at 24 h, 7 days, and 90 days comparing to those before treatment (p < 0.05). In combined treatment group, lower NIHSS at 7 d and 90 d were detected comparing to other two groups (p < 0.05). Recanalization rates were 53.33% and 60.00% in thrombolysis and mechanical groups (p > 0.05), respectively, which were significantly lower than that in combined group (83.33%) (p < 0.05). Curative rate in combined group was 70%, significantly higher than thrombolysis (46.67%) and mechanical group (53.33%) (p < 0.05). No statistical difference of curative rate was observed between thrombolysis and mechanical groups (p > 0.05). Moreover, neither significant difference of coagulation function nor platelet count was found among three groups (p > 0.05). Mechanical thrombectomy combined with thrombolysis presented favorable efficiency in the treatment of moderate to severe acute cerebral infarction than single treatment, among which the occurrence of adverse effects were similar.