| Study BackgroundThe New England Journal of Medicine published the results of five prospective randomized clinical trials in 2015,all of which showed that combined endovascular treatment and intravenous thrombolysis were significantly more effective than single intravenous thrombolytic therapy in patients with cerebral infarction with acute large vessel occlusion,but not all patients with thrombolysis had a good prognosis,and many factors could affect the outcome of endovascular treatment,The prognosis and safety of endovascular treatment in patients with acute large vessel occlusion are also receiving increasing attention.Purpose of the studyTo compare the prognosis and safety of endovascular therapy in patients with cardio embolism（CE）and large artery atherosclerosis（LAA）by analyzing the case data of patients with acute cerebral infarction caused by anterior circulation occlusion of large vessels.Study methods、A total of 107 patients with acute anterior circulation large vessel occlusion who received endovascular treatment at the National Advanced Stroke Center of ChinaJapan Friendship Hospital of Jilin University from September 2019 to September 2021 were retrospectively collected.There were 65 patients in the LAA group and 42 in the CE group.All the patients’ gender and age,smoking history,drinking history,coronary heart disease,hypertension,diabetes,atrial fibrillation,cerebral infarction or transient ischemic attack（TIA）,systolic blood pressure at admission,Blood glucose,blood lipid,homocysteine,glycated hemoglobin,baseline NIHSS score,Modified Rankin Scale（m RS）score before onset,time from onset to treatment initiation,time from femoral artery puncture to recanalization,anesthesia,intraoperative tirofiban stent placement,American The Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology（ASITN/SIR）grading and other relevant information about surgery,Modified Thrombolysis in Cerebral Infarction,m TICI score to evaluate revascularization,m RS at 90 days postoperatively to evaluate patient prognosis,stroke related pneumonia,and m TICI score.The safety of endovascular treatment was assessed by the incidence of stroke related pneumonia,symptomatic intracranial hemorrhage（s ICH）at 72 hours postoperatively,and 90-day mortality.Univariate analysis was used to compare the differences of various factors between LAA group and CE group.Study results1.Compared with CE group,LAA group had younger age,more alcohol consumption,more dyslipidemia and less atrial fibrillation.Gender,smoking,hypertension,diabetes,coronary heart disease,admission systolic blood pressure,admission random blood glucose,h BA1 c,homocysteine,baseline NIHSS score,and m RS score before onset had no statistical significance between the two groups.2.Compared with CE group,LAA group had better lateral circulation,higher proportion of preoperative application of alteplase,longer time from puncture to recanalization,higher ratio of balloon dilation,stent implantation and tirofiban use.There were no significant differences in general anesthesia,successful recanalization of blood vessels,onset to treatment time between the two groups.3.There were no statistically significant differences in prognosis and safety of endovascular treatment after 90 days between the anterior circulation LAA group and the CE group.research conclusions1.Patients in the anterior circulation LAA group were younger,smoked more,drank more alcohol,had more dyslipidemia,and had less combined atrial fibrillation than those in CE.2.Patients in the anterior circulation LAA group had a higher rate of preoperative alteplase application,longer time from puncture to recanalization,better lateral circulation,and higher rates of balloon dilation,stent placement,and use of tirofiban than those in the CE group.3.There was no statistical difference in the prognosis and safety of endovascular treatment between patients in the anterior circulation LAA group and the CE group. |
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