A Comparison of Stent-Assisted Mechanical Thrombectomy and Conventional Intra-Arterial Thrombolysis for Acute Cerebral Infarction
Journal of Clinical Neurology
; : 91-96, 2013.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-205178
Responsible library:
WPRO
ABSTRACT
BACKGROUND AND PURPOSE:
We evaluated whether stent-assisted thrombectomy (SAT) is safer or more clinically beneficial than aggressive mechanical clot disruption (AMCD) for patients with acute intracranial artery occlusion.METHODS:
We retrospectively analyzed the clinical data of 72 patients (33 with SAT and 39 with AMCD) who underwent intra-arterial thrombolysis for acute intracranial artery occlusions. Procedure parameters, clinical outcomes, and incidence of complications were compared between the SAT and AMCD groups.RESULTS:
The time interval to recanalization was shorter in SAT patients (69.2+/-39.6 minutes, mean+/-standard deviation) than in AMCD patients (94.4+/-48.0 minutes, p<0.05). Recanalization was achieved in more SAT patients (91%) than AMCD patients (80%), but with no statistically significance. Urokinase was used less frequently in SAT patients (21%) than in AMCD patients (92%, p<0.05), and the incidence of symptomatic hemorrhages was lower in SAT patients (3%) than in AMCD patients (18%, p<0.05). Device-related complications in SAT patients comprised two cases of stent fracture and one case of distal migration of a captured thrombus. The proportion of patients with good outcomes, defined as scores from 0 to 3 on the modified Rankin Scale, was similar in the two groups at discharge (SAT, 46%; AMCD, 39%), but significantly higher in the SAT group than in the AMCD group at 3 months (64% vs. 40%, p<0.05) and 6 months (67% vs. 42%, p<0.05) after discharge.CONCLUSIONS:
The outcomes and clinical parameters were better for SAT during thrombolytic procedures for acute intracranial artery occlusions than for AMCD for up to 6 months. However, some device-related complications occurred during stent interventions.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Arteries
/
Thrombosis
/
Urokinase-Type Plasminogen Activator
/
Stents
/
Cerebral Infarction
/
Incidence
/
Retrospective Studies
/
Thrombectomy
/
Stroke
/
Mechanical Thrombolysis
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of Clinical Neurology
Year:
2013
Document type:
Article