Clinical Study On The Efficacy And Safety Of Arterial Thrombolysis In Acute Ischemic Stroke Patients With Non-large Vascular Lesions Within The Time Window

Background and Objective: In today’s society,ischemic cerebrovascular disease is a common disease.Due to its high morbidity and mortality,it seriously endangers people’s health,among which ischemic stroke accounts for the highest proportion.Nowadays,our country suffered from Acute ischemic stroke(Acute ischemicstroke,AIS)gradually increase the number of state,therefore,effective prevention and control of disease development in today’s society is very important to a topic.Nowadays,mechanical thrombectomy for the treatment of Acute Large vessel occlusion(AIS-LVO)has gradually replaced intravenous thrombectomy as a perfect replacement from the old ones.ischemic thrombectomy technology is becoming more and more mature.The methods of thrombectomy are many and precise.However,there are few studies on acute anterior small vessel cerebral infarction,and the treatment methods are still relatively traditional.This paper systematically analyzed the therapeutic effect and prognosis of arterial and non-arterial thrombolysis on acute anterior small vessel cerebral infarction,and provided experience and guidance for the clinical application of arterial thrombolysis in this kind of patients.Methods: According to inclusion and exclusion criteria,a total of 276 patients were enrolled,including 116 in the intervention group and 160 in the control group.Both the intervention group and the control group were patients with acute anterior small vessel cerebral infarction.Both the intervention group had received percerebral angiography(DSA)to evaluate intracranial vascular conditions.The intervention group received alteplase under DSA monitoring and arterial thrombolysis,while the control group received conventional treatment.NIHSS scores of patients in the intervention group and control group were analyzed before treatment,24 hours after treatment and 7 days after treatment,and mRS Scores were analyzed before treatment and 3 months after discharge.The probability of intracranial hemorrhage and the probability of death 3 months after discharge were observed and recorded in the intervention and control groups.Results: There was no significant difference in NIHSS score and mRS Score between intervention group and control group before treatment(P>0.05).At 3 months after discharge,mRS Scores of patients in the intervention group were significantly lower than those in the control group(P<0.05).Compared with the control group,the number of patients with mRS Score less than 2 points in the intervention group was significantly higher,which were 66.3% and 79.3%,respectively,with significant difference(P<0.05).During treatment,1 patient in the intervention group developed intracranial hemorrhage and other complications,while no such phenomenon was observed in the control group.Three months after discharge,patients in the intervention group(0.9%)and control group(0.6%)had similar mortality,with no significant difference(P>0.05).Conclusion: Arterial thrombolysis with alteplase is effective in patients with acute anterior circulation nonvascular cerebral infarction.It is very important to give appropriate therapy to patients.Arterial thrombolysis can reduce the disability rate of patients to a certain extent,which is conducive to increasing the quality of life of patients.Moreover,studies have found that compared with conventional conservative treatment,this method has a very significant prognosis in 3 months,with fewer side effects,lower probability of intracranial hemorrhage and mortality,which is suitable for widespread clinical promotion.It has very good curative effect.