Comparative study of Solitaire AB thrombectomy and intravenous thrombolysis in cardiogenic cerebral embolism

Abstract

Objective To compare the efficacy and safety between Solitaire AB thrombectomy and intravenous thrombolysis in cardiogenic cerebral embolism. Methods Retrospective analysis of clinical data of 41 patients with cardiogenic cerebral embolism, admitted to our hospital from January 2012 to May 2015, was performed. According to different treatments, these patients were divided into Solitaire AB thrombectomy group(n=15)and intravenous thrombolysis group(n=26); patients in the Solitaire AB thrombectomy group were performed Solitaire AB thrombectomy, and patients in the intravenous thrombolysis group were given recombinant tissue plasminogen activator(rt-PA)or urokinase to achieve thrombolysis. Clinical outcomes were compared between two groups such as recanalization rates(thrombolysis in cerebral infarction[TICI]≥2B), changes of NIHSS scores after 24 hours(scores decreased equal to or at least 4 points or complete resolution of symptoms), cerebral hemorrhage rate(European Cooperative Acute Stroke Study II standard), modified Rankin scale(mRS)score improvement and mortality 90 days after treatment. Results In patients from Solitaire AB thrombectomy group, the recanalization rate was 86.67%(13/15), 10 patients(66.67%)got good outcomes in NIHSS scores, one patient(6.67%)occurred symptomatic cerebral hemorrhage; 90 days after treatment, the rate of good prognosis(mRS 0-2)was 53.33%(8/15)and no patients died. In patients from intravenous thrombolysis group, the recanalization rate was 46.15%(12/26), 9 patients(34.62%)got good outcomes in NIHSS scores, 11 patients(42.31%)occurred symptomatic cerebral hemorrhage; 90 days after treatment, the rate of good prognosis(mRS 0-2)was 23.08%(6/26)and 8 patients(30.77%)died. The above data comparisons between two groups were statistically significant(P<0.05). Conclusion As compared with intravenous thrombolysis, Solitaire AB thrombectomy has better efficacy and safety in the treatment of cardiogenic cerebral embolism. Key words: Cardiogenic cerebral embolism; Atrial fibrillation; Intravenous thrombolysis; Thrombectomy; Endovascular treatment