Comparison of intra-arterial urokinase thrombolysis and intra-arterial urokinase thrombolysis combined with stenting for isehemic stroke

Abstract

Objective To compare the safety and efficacy of intra-arterial urokinase thrombolysis alone and intra-arterial urokinase thrombolysis ＋ stenting for ischemic stroke. Methods Sixty-four patients with acute cerebral infarction in the internal carotid artery system were analyzed retrospectively. The patients were divided into intra-arterial thrombolysis group （n = 38; using urokinase only） and stenting group （n = 26; using urokinase ＋ stenting）. The medical and imaging data of the patients in both groups were collected. The revascularization rate, and symptomatic intraeranial hemorrhage and/or mortality rates were compared. The modified Rankin Scale （mRS） scores at 3 months were used to evaluate the clinical outcome in both groups. Results Of the 64 patients with ischemic stroke, 55 （85. 9%） had vascular occlusion, 9 （14. 0% ） had severe arterial stenosis. The revascularization rate in the thrombolysis group was 47.4% （18/38）, and that in the stenting group was 88. 5% （23/26）. Compared to the drug thrombolysis group, the proportion of patients whose mRS scores 〈 2 at 3 months after procedure （47. 4% vs. 73.1%, x^2 = 4. 18, P = 0. 00）. There was no sigaificant difference between the symptomatic intracranial hemorrhage rate and death rate （7.8% vs. 7.7%, x^2 = 0. 00, P =0. 62）. Conclusions When patients with acute ischemic stroke are treated with ultraearly endovascular treatment, the revascularization rate of the occlusion and severe artery stenosis treated with mechanical recanalization ＋ stenting was signaificantly higher than that of the simple intra-arterial thrombolytic drug, and the long-term clinical outcome is better. Key words: Stroke; Brain ischemia; Thrombolytic therapy; Stents; Urokinase; Treatment outcome