Clinical Analysis Of Endovascular Therapy Of Atrial Fibrillation-related Acute Anterior Circulation And Large Vessel Occlusion Stroke

Objective:To explore the clinical characteristics and prognosis of intravascular therapy in patients with acute anterior circulation stroke caused by acute occlusion of large cerebral vessels associated with atrial fibrillation.Methods:A retrospective analysis was performed on 33 patients with atrial fibrillation-related acute anterior circulation great vessel occlusion stroke who were treated with endovascular therapy from September 2016 to September 2018(atrial fibrillation group)and 35 patients with anterior circulation great vessel occlusion caused by other causes(non-atrial fibrillation group).Gender,age,history of hypertension,history of diabetes,INR,NIHSS score at admission,time of vessel opening,operation time,endovascular treatment efficiency,incidence of symptomatic intracranial hemorrhage after surgery,NIHSS score at 7 days after surgery,mRS score at 90 days after surgery and other indicators of the two groups were statistically analyzed and evaluated.Results:(1)There was no significant difference between the atrial fibrillation group and the non-atrial fibrillation group in terms of gender,age,history of hypertension,composition of diabetes mellitus,and effective open rate(p > 0.05).Preoperative NIHSS score of atrial fibrillation group was significantly higher than that of non-atrial fibrillation group(t = 3.352,p < 0.05),which means atrial fibrillation group worse on admission.(2)There was no significant difference in the average time taken for the first recanalization from femoral artery puncture to occlusion between the atrial fibrillation group and the non-atrial fibrillation group,but the average operation time of atrial fibrillation group was better than that of the non-atrial fibrillation group(t=6.034,p < 0.05).(3)Compared with the non-atrial fibrillation group,the incidence of symptomatic intracranial hemorrhage did not increase significantly in the atrial fibrillation group.The death rate(mRS 6 points)of the patients 90 days after surgery was lower than that of the non-atrial fibrillation group(p < 0.05).(4)The atrial fibrillation group was superior to the non-atrial fibrillation group in improving the total effective rate of postoperative NIHSS at 7 days and improving mRS recovery rate at 90 days after surgery(p < 0.05).Conclusion:(1)Patients with atrial fibrillation-related acute anterior circulation large vessel occlusive stroke spend less time in endovascular surgery in the early stage.(2)The NIHSS score of patients with atrial fibrillation-related acute anterior circulation large vessel occlusive stroke was improved 7 days after endovascular therapy and the therapy was effective.(3)The incidence of symptomatic intracranial hemorrhage after endovascular therapy and the mortality at 90 days were lower in patients with acute anterior circulation large vessel occlusion stroke associated with atrial fibrillation.(4)Endovascular therapy is effective for patients with atrial fibrillation-related acute large vessel occlusion,but there are many factors affecting the prognosis of patients.Preoperative screening of patients,operative proficiency,vascular protection and postoperative patient management all have an impact on the prognosis of patients.At the same time,due to the limitations of the study time,number of cases and postoperative management,the conclusion has certain limitations.