The Clinical Observation Of Emergency Endovascular Recanalization Therapies For Acute Ischemic Stroke

Objective:To discuss the efficacy,safety and individuation of emergency endovascular recanalization therapies for acute ischemic stroke.Methods:The clinical data of36patients with acute ischemic stroke who underwent emergency operation from January2011to January2013were retrospectively analyzed, to evaluate the technical success rate, efficacy and the surgical procedure.Results:In the36patients with acute ischemic stroke who underwent emergency operation,26cases got recanalization, technical success rate was72.2%(26/36), including21cases achieve immediate postoperative blood vessel recanalization (TIMI grade3),5cases of partial recanalization (TIMI grade2). In the26cases whose vessel have got recanalization,9patients underwent superselective intra-arterial contact thrombolysis and micro-thread clot disruption(mechanical thrombolysis),17patients underwent mechanical thrombolysis joint the mechanical endovascular recanalization therapies including balloon mechanical expanding, the self-expanding type stent implantation or Solitaire stent clot-retrieval including single balloon dilation in1case,4cases of mechanical thrombolysis combined balloon expansion, mechanical thrombolysis combined the stent implantation in2cases, mechanical thrombolysis combined with balloon expansion and stent implantation in3cases, single Solitaire stents in2cases, mechanical thrombolysis combined Solitaire stents,balloon expansion and stent implantation in5cases. In the36patients with acute ischemic stroke who underwent emergency operation,there are10cases of recanalization failed,postoperative death in patients with13cases (36.1%),3cases died of intracranial hemorrhage (8.3%), all occurred within12hours after surgery,10cases died of large infarction (27.8%), including6cases of acute thrombosis,4cases whose vessel was not opened and infarction symptoms aggravated gradually.In the90days’follow-up, the discharge patients who achieved good prognosis (MRS≤2) accounted for41.7%(15/36), the good prognosis rate of patients with complete recanalization of blood vessel was66.7%(14/21), the good prognosis rate of patients with lateral branch compensatory verified by preoperative DSA was52.4%(11/21).Conclusions:Emergency endovascular recanalization for acute ischemic stroke is feasible, safe and effective.It is a reflection of individualized, fast, safe and efficient treatment ideas and principles in the treatment of AIS, and is likely to be the first choice in the future.