关键词: 重组组织型纤溶酶原激活剂; 静脉溶栓; 血管内治疗; 急性缺血性卒中

Abstract:

Objective To observe the clinical efficacy and safety of rt-PA intravenous thrombolysis bridging endovascular therapy in patients with acute ischemic stroke (AIS). Methods Data of AIS patients who receiving intravenous thrombolysis and endovascular treatment in the Department of Critical Care of the First Hospital of Zhengzhou from January 2017 to December 2017 were selected. According to the treatment method, the patients were divided into intravenous thrombolysis group and the bridging group. The intravenous thrombolysis group only received rt-PA intravenous thrombolysis, while the bridging group received rt-PA intravenous thrombolysis followed by endovascular treatment. The primary outcome was mRS score at 3 months, secondary outcome were the NIHSS score at 24 hours, 3 days and 30 days after the procedure. Safety outcome was the symptomatic intracranial hemorrhage and other bleeding from other sites within 2 days and all-cause death within 10 days. Results A total of 56 patients were included in this study, with a mean age of 60.77±12.72 years old and 35 (62.5%) males, 39 patients in intravenous thrombolysis group and 17 patients in the bridging treatment group. The rate of mRS ≤2 at 3 months in the bridging treatment group was higher than that in intravenous thrombolysis group (88.2% vs 56.4%, P =0.021). There was no statistical difference in NIHSS score at 24 hours, 3 days and 30 days after treatment. There were no statistical differences in the safety outcome between the two groups. Conclusions rt-PA intravenous thrombolysis bridging endovascular treatment can improve the prognosis of AIS patients at 3 months.

Key words: Recombinant tissue plasminogen activator; Intravenous thrombolysis;Endovascular treatment; Acute ischemic stroke