Comparison of the therapeutic efficacy between simple arterial thrombolysis and mechanical thrombectomy combined with arterial thrombolysis for acute cerebral infarction at its ultra-early stage

Objective To compare the therapeutic efficacy between the simple arterial thrombolysis and mechanical thrombectomy combined with arterial thrombolysis in treating acute cerebral infarction at its ultra-early stage,and to determine the optimal method more beneficial to endovascular recanalization. Methods During the period from Oct.2009 to May 2011,emergency interventional therapy was carried out in 55 patients with acute cerebral infarction at its ultra-early stage.Arterial thrombolysis using urokinase combine with mechanical thrombectomy was employed in 25 patients(combination group),while pure arterial infusion of urokinase was adopted in 30 patients(urokinase group).After the treatment,the vascular recanalization and the recovery of the dysneuria were estimated,and the thrombolysis efficacy was compared between the two methods.Results The vascular recanalization rate in combination group and urokinase group were 92%(23/25) and 60%(18/30),respectively.After the treatment,the one-hour NIHSS and ADL scores of the combination group were 8.6±2.5 and 20.0±4.6,respectively,while the 24-hour NIHSS and ADL scores of the combination group were 9.0±1.8 and 17.0±2.5,respectively,both of which were significantly better than those of the urokinase group(P0.05).The dosage of urokinase and the time of thrombolysis in combination group were(36.8±8.4)×10~4 units and(35.3±11.6) minutes,respectively. The dosage of urokinase and the time of thrombolysis in urokinase group were(50.4±15.3)×10~4 units and (55.7±13.3) minutes,respectively.Statistically significant difference existed between the two groups(P0.05).Conclusion The emergency use of mechanical thrombectomy combined with arterial thrombolysis is very effective for acute cerebral infarction at its ultra-early stage,and its therapeutic efficacy is superior to that of pure arterial infusion of urokinase.