Abstract
Objective To explore the correlation between selection of time window for acute cerebral infarction (ACI) and efficacy of intravascular stent implantation. Methods The clinical data of 84 ACI patients treated in our hospital from March 2019 to March 2020 were selected for the retrospective analysis, all study subjects received intravascular stent implantation, and after discharge, patients were assessed by the Modified Rankin Scale (mRS) and divided into the good prognosis group (n = 46, mRS score ≤2 points) and poor prognosis group (n = 38, mRS score >2 points). The clinical data of patients in the two groups at admission underwent univariate analysis, the indicators presenting P < 0.05 were included in the logistic regression model, and the correlation between patients' treatment time window and clinical effect was analyzed by multivariate logistic regression analysis and linear fitting analysis. Results According to the multivariate logistic regression analysis, low-density lipoprotein (LDL), time window, and blood glucose level before treatment were the independent factors affecting patients' treatment effect and were associated with the efficacy of intravascular stent implantation (r was 0.790, 0.889, and 0.672, respectively). Conclusion LDL, time window, and blood glucose level before treatment are the important factors affecting the efficacy of intravascular stent implantation for ACI patients, among which the time window is most significantly associated with the clinical effect. Therefore, ACI patients should accept clinical treatment as early as possible.
Highlights
Cerebrovascular diseases rank the first in the cause of death in China, among which acute cerebral infarction (ACI) accounts for approximately 80% [1]
At the onset of ACI, irreversible necrosis occurs in the ischemic core area, and the ischemic periphery is the ischemic penumbra with damaged neurological function but the neurons are still alive, so effective evacuation of the blocked blood vessels is the key to rescuing the ischemic penumbra [3, 4]
Patients were lying flat on the operating table, after routine disinfection, draping, and local anesthesia, femoral artery puncture and sheathing were performed, 5F catheter was transmitted under wire guidance to the proximal end of stenosed artery for imaging, after determining the route, diameter, and length of stenosed lesion of the vessel, a suitable stent was selected and relieved precisely under wire guidance, after stent implementation, digital subtraction angiography (DSA) was performed to check the stent relief status and whether the remote vessel was smooth, and when the imaging showed that the stent was well placed, the catheter and wire were withdrawn, the arterial sheath was pulled out, and the puncture point was pressed [12]
Summary
Cerebrovascular diseases rank the first in the cause of death in China, among which acute cerebral infarction (ACI) accounts for approximately 80% [1]. At the onset of ACI, irreversible necrosis occurs in the ischemic core area, and the ischemic periphery is the ischemic penumbra with damaged neurological function but the neurons are still alive, so effective evacuation of the blocked blood vessels is the key to rescuing the ischemic penumbra [3, 4]. According to the Chinese Guidelines for Diagnosis and Treatment of Acute Ischemic Stroke 2018, the effective time window for rescuing the ischemic penumbra is within 4.5 h, and carrying out treatment within the time window can effectively evacuate the blocked blood vessels and restore blood flow, effectively avoiding irreversible brain tissue necrosis triggered by prolonged ischemia in ACI patients’ brain cells [6, 9]. A clinically comparative study was conducted to explore the important factors affecting the efficacy of intravascular stent implantation and analyze the correlation between time window and patient outcome, so as to provide a reliable treatment basis for such patients
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