The Study On The Safety And Efficacy Of 4.5h To 12h Thrombolysis For The Treatment Of Acute Basilar Artery Occlusion Based On Non-enhanced CT PC-ASPECTS Scoring Guidance

Objective We aimed to explore the safety and efficacy of t PA intravenous thrombolysis in patients with non-enhanced CT in the basal artery occlusion(BAO).Methods this was a single-center,prospective,cohort study,were retrospectively analyzed from patients with BAO from Tangshan Stroke Thrombolysis registration database(Tangshan Stroke Thrombolysis Registry,TSTR),all received t PA intravenous Thrombolysis treatment,and no mechanical bolt.According to onset to thrombolysis time(OTT),the patients were divided into standard time window group(OTT ? 4.5 h)and the expanded time window group(4.5 h < OTT ?12h and the PC-ASPECTS score of non-enhanced CT was greater than 8).We used chi-square test or Fisher's exact probability method for calculating the odds ratio(odds ratio,OR)and 95% confidence interval(the confidence interval,CI),and compared the safety and efficacy of two groups of patients have indiscriminate ending.The safety outcome measures included: symptomatic intracerebral hemorrhage in 7d and all intracerebral hemorrhage and 90 d death;The efficacy outcome indicators include: the prognosis of 90d(m RS is less than 1)and the proportion of life self-care(m RS = 2).Results a total of 122 BAO patients were included in this study,including 86 in standard time window group and 36 cases in the extended time window group.There was no significant difference between the two groups' demographic and baseline clinical characteristics(P>0.05).Chi-square test or Fisher's exact probability method analysis showed that 4.5 h < OTT ?12h and the PC-ASPECTS score of non-enhanced CT was greater than 8 group 90 d good prognosis in patients with(22.9% vs 47.1%,OR = 0.49,95% CI = 0.25-0.93,P = 0.01)and life care(31.4% vs 51.8%,OR= 0.61,95% CI = 0.36-0.97,P = 0.04)group was significantly lower than the proportion of the standard time Windows;However,the incidence of symptomatic cerebral hemorrhage(2.8% vs 8.1%,P= 0.43)and all intracerebral hemorrhage(11.1% vs 15.1%,P= 0.56)and the 90 d mortality(20.0% vs 23.5%,P= 0.67)were not statistically significant.Conclusions the expanded time window thrombolytic therapy for the pc-aspects scoring guidance based on non-enhanced CT is safe,but the curative effect is inferior to that of the standard time window.Therefore,we urgently need to find other imaging markers to screen the patients who can still benefit from the superwindow thrombolysis.