Comparation of the effect of Solitaire stent thrombectomy versus intravenous thrombolysis on stroke due to acute vertebrobasilar occlusion in the elderly

Abstract

Objective To compare the efficacy and safety of solitaire stent thrombectomy versus intravenous thrombolysis for treatment of elderly stroke patients with acute vertebrobasilar occlusion. Methods Clinical data of 76 patients with acute vertebrobasilar occlusion at the neurology department of Anyang People's Hospital from May 2014 to July 2017 were retrospectively analyzed.Patients were divided into two groups: solitaire stent thrombectomy group(n=30)and intravenous thrombolysis group(n=46). Recanalization rates, score improvement rate in National Institutes of Health Stroke Scale(NHISS)after 24 hours of treatment, symptomatic intracranial hemorrhage rate and mortality at 90 days after treatment were compared between the two groups. Results The recanalization rate, NIHSS score improvement rate at 24 hours after treatment and the improvement rate of Modified Rankin Scale(mRS)score at 90 days after treatment were significantly higher in the solitaire stent thrombectomy group than in the intravenous thrombolysis group〔86.7%(26/30)vs.45.7%(21/46), 66.7%(20/30)vs.34.8%(16/46), 53.3%(16/30)vs.23.9%(11/46), χ2=6.543, 3.900 and 3.761, P=0.012, 0.041 and 0.046, respectively〕. No significant difference in incidence of intracranial hemorrhage was found between the two groups〔6.7%(2/30)vs.19.6%(9/46), χ2=0.813, P=0.357〕. The mortality at 90 days after treatment were significantly lower in the solitaire stent thrombectomy group than in the intravenous thrombolysis group〔0.0%(0/30)vs.30.4%(14/46), P=0.017〕. Conclusions Solitaire stent thrombectomy versus intravenous thrombolysis has better efficacy and higher safety in treating acute stroke due to vertebrobasilar occlusion in elderly patients. Key words: Arterial occlusive diseases; Stroke; Thrombolytic therapy