Effects of aspiration combine stent for thrombectomy on cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window

doi:10.3877/cma.j.issn.2095-123X.2023.06.006

Abstract

Abstract:

Objective

To investigate the effects of aspiration combine stent for thrombolectomy on cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window.

Methods

A total of 97 patients with posterior circulation ischemic stroke beyond the time window who were admitted to Neurology Department of Changshu Hospital Affiliated to Xuzhou Medical University from June 2018 to June 2022 were selected as the study subjects. They were divided into drug thrombolysis group (n=48, thrombolysis with recombinant tissue plasminogen activator) and thrombectomy group (n=49, aspiration combine stent for thrombectomy) based on treatment plan. Cerebral blood perfusion, serum neuron-specific enolase (NSE) and endothelial nitric oxide synthase (eNOS) levels, adverse reactions, and prognosis were compared between two groups before and after treatment.

Results

After treatment, the cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP) and cerebral blood flow (CBF) of two groups significantly improved compared to before treatment, the CBV and CBF of the thrombectomy group were significantly higher than those of the drug thrombolysis group, while the MTT and TTP were significantly shorter than those of the drug thrombolysis group, and the differences were statistically significant (P<0.05). After treatment, the serum NSE level was lower than before treatment, and the eNOS level was higher than before treatment in two groups of patients, the serum NSE level in the thrombectomy group was lower than that in the drug thrombolysis group, and the eNOS level was higher than that in the drug thrombolysis group, with statistical significance (P<0.05). The incidence of adverse reactions in the thrombectomy group (16.33%) was lower than that in the drug thrombolysis group (35.42%), and the good prognosis rate (89.90%) was higher than that in the drug thrombolysis group (72.92%), with statistical significance (P<0.05).

Conclusion

Aspiration combine stent for thrombectomy is beneficial to improve cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window, with significant curative effect and good safety.

Key words: Aspiration combine stent for thrombectomy, Beyond the time window, Posterior circulation ischemic stroke, Cerebral blood perfusion

Wangjun Li, Yunxia Wang. Effects of aspiration combine stent for thrombectomy on cerebral blood perfusion in patients with posterior circulation ischemic stroke beyond the time window[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2023, 13(06): 352-357.

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References 19

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组别	例数	年龄（岁，Mean±SD）	性别（男/女）	病程（h，Mean±SD）	体质量指数（kg/m²，Mean±SD）	基础疾病（高血压/高脂血症/房颤/糖尿病）
药物溶栓组	48	65.64±6.27	29/19	12.11±1.76	24.85±5.11	20/11/8/9
取栓组	49	63.51±6.71	31/18	12.35±1.84	24.92±5.34	22/9/10/8
t/χ²值		1.615	0.083	1.475	0.066	0.566
P值		0.110	0.773	0.144	0.948	0.904

组别	例数	年龄（岁，Mean±SD）	性别（男/女）	病程（h，Mean±SD）	体质量指数（kg/m²，Mean±SD）	基础疾病（高血压/高脂血症/房颤/糖尿病）
药物溶栓组	48	65.64±6.27	29/19	12.11±1.76	24.85±5.11	20/11/8/9
取栓组	49	63.51±6.71	31/18	12.35±1.84	24.92±5.34	22/9/10/8
t/χ²值		1.615	0.083	1.475	0.066	0.566
P值		0.110	0.773	0.144	0.948	0.904

组别	例数	时间	MTT（s）	CBV（mL/100 mg）	TTP（s）	CBF[mL/（100 g·min）]
药物溶栓组	48	治疗前	16.52±4.11	65.24±9.36	33.84±7.15	32.84±6.75
		治疗后	12.25±3.09	84.62±11.45	24.21±7.08	49.52±5.26
		t值	8.218	12.904	9.377	19.244
		P值	<0.001	<0.001	<0.001	<0.001
取栓组	49	治疗前	16.85±4.38	67.35±9.48	32.05±7.29	32.61±6.84
		治疗后	8.65±3.37^a	91.25±12.74^a	18.42±6.49^a	54.11±5.59^a
		t值	14.813	15.059	13.848	24.216
		P值	<0.001	<0.001	<0.001	<0.001

组别	例数	时间	MTT（s）	CBV（mL/100 mg）	TTP（s）	CBF[mL/（100 g·min）]
药物溶栓组	48	治疗前	16.52±4.11	65.24±9.36	33.84±7.15	32.84±6.75
		治疗后	12.25±3.09	84.62±11.45	24.21±7.08	49.52±5.26
		t值	8.218	12.904	9.377	19.244
		P值	<0.001	<0.001	<0.001	<0.001
取栓组	49	治疗前	16.85±4.38	67.35±9.48	32.05±7.29	32.61±6.84
		治疗后	8.65±3.37^a	91.25±12.74^a	18.42±6.49^a	54.11±5.59^a
		t值	14.813	15.059	13.848	24.216
		P值	<0.001	<0.001	<0.001	<0.001

组别	例数	时间	NSE（μg/L）	eNOS（U/mL）
药物溶栓组	48	治疗前	29.66±3.15	3.18±0.62
		治疗后	22.38±3.28	7.54±0.85
		t值	15.688	41.098
		P值	<0.001	<0.001
取栓组	49	治疗前	29.15±3.27	3.25±0.67
		治疗后	17.62±3.49^a	10.74±0.96^a
		t值	23.634	63.671
		P值	<0.001	<0.001

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