A Comparative Study Of Endovascular Interventional Therapy And Butylphthalide Therapy In Acute Anterior Circulation Great Vessel Occlusion In Cerebral Infarction

Objective:To compare the efficacy and safety of endovascular interventional therapy with butylphthalide drug therapy in patients with acute anterior circulation large vessel occlusion of cerebral infarction.Methods:Patients with acute cerebral infarction with anterior circulation occlusion of the large vessel were collected from the department of neurology,Tangshan Gongren hospital from September 2018 to November 2019.The patients who met the inclusion criteria were allocated to the butylphthalide group or the intervention therapy group according to the wishes of the patients and their families.The butylphthalide group:Sodium butylphthalide injection was given on the basis of active medical treatment of the domestic guidelines,with intravenous infusion 100ml twice a day for 14 days.Then the injection was changed into butylphthalide soft capsule with orally 0.2g three times a day for 3 months.Interventional therapy group:on the basis of active medical treatment,the emergency interventional treatment is routinely performed in accordance with the endovascular treatment procedures of the interventional department of our hospital.The efficacy and safety of the two groups were compared and analyzed:the good prognosis at 3 months,the good early recovery,the intracranial hemorrhage within 72 hours after onset and the death within 3 months.Results:A total of 51 patients with acute anterior circulation large vessel occlusion with cerebral infarction were involved,including 31 in the butylphthalide group.However,3 cases shed during follow-up which means that there were 28 final participants of butylphthalide group.There were 20cases in the interventional treatment group,without any fall-off.There was no significant difference between the patients with good prognosis after 3 months in the butylphthalide group(39.3%)and the interventional treatment group(40.0%)(χ~2=0.002,P=0.960).Patients with good early recovery in the butylphthalide group were 3.6%lower than those in the intervention group(15.0%),with no statistically significant difference(χ~2=0.779,P=0.377).The incidence of intracranial hemorrhage within 72 hours after onset in the intervention group was 30.0%,significantly higher than that in the butylphthalide group(3.6%),and the difference was statistically significant(χ~2=4.592,P=0.032).The 3-month mortality rate in the intravascular intervention group was 15.0%,higher than that in the butylphthalide group(3.6%),but the difference was not statistically significant(χ~2=0.779,P=0.377).Conclusion:Butylphthalide treatment in patients with acute anterior circulation large vessel occlusion cerebral infarction has similar long-term prognosis and may reduce the risk of intracranial hemorrhage compared with those of endovascular interventional therapy.