Clinical Analysis Of The Effect Of Intravascular Therapy For Patients With Acute Ischemic Stroke

Objective: It is to analyze the data of acute ischemic stroke patients to explore the clinical effectiveness of intravascular therapy in our department.Methods:A retrospective analysis was about the clinical data of 187 patients with acute ischemic stroke(AIS)who were conformed to the inclusion criteria,and underwent endovascular treatment during the period from May 2015 to March 2017 in the Department of neurosurgery of the First Affiliated Hospital of Shihezi University School of Medicine.We did a related data analysis with the changes of preoperative and postoperative stroke through the National Institutes of Health Institute of scale score(NIHSS score)and Glasgow Coma Scale(GCS score)about the patients,and vascular reperfusion,the mean time of visiting process,operative time,postoperative complications,the safety and effectiveness of endovascular treatment,and the modified Rankiri scale score(mRs score)of postoperative 3months Results: There were 118 cases of hypertension,53 cases of diabetes,8 cases of atrial fibrillation,84 cases of smoking,60 drinking and 31 obesity in 187 cases of AIS.The mean time of patients visiting was(303.40 ± 327.73)min after the onset of the disease.The average operation time of the intravascular treatment was(77.51 ± 29.43)min.The preoperative NIHSS score was(14.87 ± 4.44)scores,and another NIHSS score was(9.35 ± 7.14)scores in next days after operation of patients,and the difference was statistically significant(P<0.05).The preoperative GCS score was(10.83 ± 4)scores,and another GCS score was changed to(11.65 ± 3.91)scores in the first day after the operation,and the difference was statistically significant(P<0.05).The recanalization rate was 91.44%(TICI 2B or 3)in the treatment of endovascular surger.The distal cerebral vessels were completely perfused(TICI 3)by 130 cases of AIS patients after arterial thrombolytic therapy.It had get ideal perfusion from distal artery or branch vessel occlusion in the arterial thrombolysis combined with mechanical thrombectomy group in 9 patients,and all TICI grade reached III level.It had been improved(TICI 2B grade)in 3 patients who received stent thrombectomy and 1 case who had stent thrombectomy plus stent implantation in distal perfusion of the responsible vessels.And the remaining 36 cases(90%)had good therapeutic effect,and the distal occlusion of the vessels was perfused completely in the stent thrombectomy treatment group.There were a total of 75 patients happed with complications in 7 days after operation,and the postoperative complication rate was 40.10%,the incidence of pulmonary infection and cerebral edema was higher than ather complications.And it showed that 130 cases(69.52%)patients gained good prognosis(mRs≤2)by clinical follow-up after 3 months.Conclusion:It is effect to use arterial thrombolysis,stent thrombolysis,stent implantation,other endovascular treatment methods and the combination of treatment methods to open the occlusion of blood vessels and to promote neurological recovery.And the treatment effect is effective,the treatment process is safety.And stent thrombectomy can dredge the large occlusion vessels in a short time and improve the prognosis in the case of large vascular occlusion.