Mechanical auxiliary arterial thrombolytic therapy for the treatment of acute ischemic stroke

Abstract

Objective To evaluate the clinical efficacy and safety of mechanical auxiliary arterial thrombolytic therapy in treating acute ischemic stroke.Methods During the period from Jan.2007 to Oct. 2010 a total of 28 patients with acute ischemic stroke were treated in the hospital.Mechanical auxiliary arterial thrombolysis and intra - arterial infusion of urokinase was carried out,which was started within 90 - 450 minutes after the onset of the disease.The mechanical auxiliary thrombolysis means included cutting up of the thrombus with the guidewire,aspiration of the thrombus through the catheter,stent implantation,etc. Postoperative vascular recanalization rate,symptomatic as well as asymptomatic intracranial hemorrhage were recorded.Three months after the operation,modified Rankin Scale(mRS) score was calculated. Results Successful recanalization was achieved in 23 patients,with a recanalization rate of 82.1%.The average time for obtaining vascular reopen was 65.22 minutes.Three months after the treatment,the mean mRS score was≤3.Among the 5 cases who failed to respond to the treatment,death occurred in two,mRS score = 4 was seen in one,and mRS score≤3 was seen in two.In successful recanalization patients, mechanical auxiliary arterial thrombolytic therapy did not increase the incidence of bleeding complications. Conclusion Mechanical auxiliary arterial thrombolytic therapy is safe and effective for the treatment of acute ischemic stroke.This technique can reduce the usual amount of urokinase,quicken the vascular recanalization and increase the recanalization rate.