RESUMEN
Objective To compare the therapeutic differences between stent-thrombectomy combined with urokinase thrombolysis and simple arterial urokinase thrombolysis in treating patients with acute cerebral infarction.Methods Arterial urokinase thrombolysis was carried out in 28 selected patients with acute cerebral infarction,admitted to our hospital in 2011 (urokinase group),while Solitaire AB stent-thrombectomy combined with arterial urokinase thrombolysis was carried out in 29 patients with acute cerebral infarction,admitted to our hospital in 2012 (combination group).Postoperative indices,including National Institutes of Health Stroke Scale (NIHSS),recanalization rate and intracranial hemorrhage incidence,were analyzed between the two groups.Results Recanaliztion rate of combination group was detailed as:middle cerebral artery in 20 patients,internal carotid artery in 3 patients,and vertebral-basilar artery in 4 patients,with a total recanalization rate of 93.1％.No postoperative hemorrhage was confirmed; two patients diagnosed as having internal carotid artery occlusion died.Recanaliztion rate of urokinase group was detailed as:middle cerebral artery in 15 patients,internal carotid artery in 3 patients,and vertebral-basilar artery in 0 patients,with a total recanalization rate of 64.2％; postopertive intracranial hemorrhage was noted in 5 patients and death in 8.For combination group,postoperative fourteen-day NIHSS scores decreased by 11.40±4.57 as compared with preoperative NIHSS scores; for urokinase group,postoperative fourteen-day NIHSS scores decreased by 11.40±4.57 as compared with preoperative NIHSS scores; significant differece was noted between the two groups (P＜0.05).Postoperative satisfactory rehabilitation (modified Rankin scale scores＜2) in combination group and urokinase group appeared in 20 and 17 patients,respectively,after 3 months of follow up.Conclusion The efficacy of stent-thrombectomy combined with arterial urokinase thrombolysis is superior to that of simple arterial urokinase thrombolysis in patients with acute cerebral infarction.