Transcranial Doppler-assisted intra-arterial thrombolysis for patients with acute ischemic stroke / 中华神经医学杂志

ABSTRACT

Objective To investigate the clinical efficacy of transcranial Doppler(TCD)-assisted interventional intra-arterial thrombosis in patients with acute ischemic stroke.Methods This clinical trial enrolled 22 patients with acute ischemic stroke(13 with occlusion of the middle cerebral artery within 6 h of symptom onset; 9 with occlusion of the base artery within 12 h of symptom onset); occlusive arterial cannula was performed and recombinant tissue plasminogen activator(rt-PA,20 mg)was injected to perform interventional intra-arterial thrombosis; and TCD ultrasonography of low frequency(2 MHz)and low intensity(0.25 W/cm2)was performed to assist the thrombosis.Cranial CT was performed again right after the operation and 24 h after the operation to observe the recanalization rate and intracranial hemorrhage; NIHSS scores and Barthel index scores were compared before and after the operation.Results The percentage ofrecanalization was 77.27％(17/22),including 22.73％(5/22)complete recanalization and 54.55％(12/22)partial recanalization; non-symptomatic intracerebral hemorrhage occurred in 3 patients and no symptomatic intracerebral hemorrhage was noted.NIHSS and Barthel index scores after the operation were obviously higher than those before the operation,indicating that favorable outcomes were achieved after thrombosis.Conclusion TCD-assited interventional intra-arterial thrombosis with rt-PA,significantly improving the recanalization rate of occlusive artery and remarkably reducing the happening ofintracerebral hemorrhage,can improve the prognosis and enjoy good clinical efficacy and safety in treatment of acute ischemic stroke.