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Objective To investigate the safety and effectiveness of rescue stenting after failure of mechanical thrombectomy in patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). Methods From December 2015 to December 2017, patients with AIS caused by LVO and treated with Solitaire AB stent thrombectomy in the Fifth Central Hospital of Tianjin were enrolled retrospectively. CT scans were performed within 24 h after surgery. Symptomatic intracraninal hemorrhage (sICH) was defined as CT confirmed intracranial hemorrhage and the National Institutes of Health Stroke Scale score increased ≥4. Clinical outcomes were assessed using the modified Rankin Scale at 90 d after onset, and 0 to 2 was defined as good outcome. According to whether to receive rescue stenting or not, the patients were divided into 2 groups. The clinical outcomes and incidence of sICH were compared between the 2 groups. Results A total of 39 patients were enrolled. Among them, 29 (74. 3％) were successfully recanalized by mechanical thrombectomy and 10 (25. 6％) performed stenting after failure of mechanical thrombectomy. Four (40. 0％) in the stenting group and 11 (37. 9％) the non-stenting group had good outcomes respectively at 90 d. There was no significant difference (P = 1. 000). Two patients (20. 0％) and 1 patient (3. 4％) developed sICH within 24 h after operation in the stenting group and the non-stenting group respectively. There was also no significant difference (P = 0. 156). Conclusions Rescue stenting can be used as a safe and effective remedy for patients with failure of mechanical thrombectomy.
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Objective To compare the outcomes of Solitaire AB stent mechanical thrombectomy for the treatment of large-artery atherosclerotic stroke (LAA) and cardioembolic stroke (CES).Methods Acute ischemic stroke patients treated with Solitaire stent retriever device were enrolled retrospectively. They were divided into either a LAA group or a CES group according to the etiology. The outcomes in both groups were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for poor outcome (defined as the modified Rankin Scale score > 2) at 90 d after onset. Results A total of 39 patients were enrolled in the study. There were 18 patients in the LAA group (49. 2％), 6 (33. 3％) had good outcome at 90 days; there were 21 patients (50. 8％) in the CES group, 9 (42. 9％) had good outcome at 90 days. There was no significant difference in the the good outcome rate at 90 days in both groups (P = 0. 223). Multivariate logistic regression analysis showed that only age was independently associated with poor outcome (odds ratio 1. 107, 95％ confidence interval 1. 016-1. 206; P = 0. 047), and stroke etiology subtype was not independently associated with poor outcome (odds ratio 0. 671, 95％ confidence interval 0. 078- 5. 743; P = 0. 716). Conclusions There was no significant difference in the clinical outcome between the patents with LAA and CES who received mechanical thrombectomy with Solitaire AB stent.
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The present study was designed to investigate the protective effects and mechanism of inactivated lactobacillus (ILA) on cerebral ischemia reperfusion injury (CIRI) in rats. In this experiment, 30 male Sprague Dawley rats were randomly divided into control group, IRI groups, and ILA group. A middle cerebral artery occlusion and reperfusion model was prepared. The rats were killed after 24 hours of recovery of blood flow of cerebral ischemia resulting from 60-min occlusion. The cerebral infarction volume and neurological scores were assayed by staining and behavioral observation. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were assayed by biochemical kits. Cell apoptosis was assayed by Tunnel and the Toll-like receptor (TLR)-4, IkB, and A20 were assayed by western blot. The neurobehavioral scores in IRI rats were significantly lower compared to the control group while ILA improved the neurobehavioral scores of the ILA groups. The cerebral infarction volume and neural cell apoptosis of rats in the ILA groups decreased significantly compared with those in the IRI group. In addition, MDA level in the ILA groups decreased whereas SOD activity increased compared to the IRI group. Moreover, ILA also inhibited the expression of TLR-4 and promoted the expression of IkB and A20. ILA inhibited the apoptosis of neural cells, decreased cerebral infarction volume, and reduced oxidative stress through inhibition of TLR-4/NF-kappa B signaling, improving neurobehavioral scores. Thus from the present study it was concluded that ILA has protective effect on CIRI.