Comparison Of Effects Of Intravenous Thrombolysis And Intravenous Thrombolysis Bridging Endovascular Therapy In The Treatment Of Acute Ischaemic Stroke With Large Vessel Occlusion

Objective:To observe the efficacy and safety of intravenous thrombolysis and intravenous thrombolysis bridging endovascular therapy in the treatment of acute anterior circulation ischaemic stroke with large vessel occlusion and to discuss the optimal treatment of acute anterior circulation ischaemic stroke with large vessel occlusion.Methods:Clinical data of 80 patients with acute anterior circulation ischaemic stroke with large vessel occlusion between January 2017 to December 2018 at the advanced stroke center of our hospital were retrospectively analyzed.The patients were divided into two groups according to the different therapies:intravenous thrombolysis plus standard medical treatment group(IVT)and intravenous thrombolysis bridging endovascular therapy plus standard medical treatment group(BET)with 40 patients each.The clinical prognosis at 90 days follow-up of two groups were assessed by modified Rinkan Scale score(mRS).Neurofunctional deficits in stroke patients were assessed by NIHSS scores.The final recanalization rate and complications related to the procedure were recorded.Results:l.There was no significant difference in age,gender,systolic pressure and diastolic pressure on admission,NIHSS score on admission,risk factors(hypertension,diabetes,coronary atherosclerotic heart disease,atrial fibrillation,dyslipidemia,smoking)and location of vascular occlusion between the two groups(P>0.05).2.The final recanalization rate was 12.5%(5/40)in IVT group,while in BET group,the final recanalization rate was 90.0%(36/40).The difference between the two groups was statistically significant(P<0.001).3.The 24-hour NIHSS score of IVT group was 14.13±5.48,while that of BET group was 12.40 ± 5.39.There was no significant difference between the two groups(P>0.05).The rate of good prognosis(mRS<2)in IVT group and BET group was 27.5%and 52.5%,respectively.The difference between the two groups was statistically significant(P<0.05).There was no significant difference in symptomatic intracerebral hemorrhage rate and 3-month mortality between the two groups(P>0.05).Conclusion:l.The effect of intravenous thrombolysis is limited in the treatment of acute anterior circulation ischaemic stroke with large vessel occlusion.Intravenous thrombolysis bridging endovascular therapy can significantly improve the recanalization rate and clinical prognosis.2.Intravenous thrombolysis bridging endovascular therapy may be the optimal treatment of acute anterior circulation ischaemic stroke with large vessel occlusion.