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
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