Comparison of two kinds of therapies in acute anterior circulation stroke patients / 中华神经医学杂志

ABSTRACT

Objective To explore the intra-arterial therapies and prognostic predictors of anterior circulation stroke patients.Methods Fifty-nine anterior circulation stroke patients,admitted to our hospital from May 2011 to June 2014,were divided into two groups:intra-arterial therapy (IAT) group (n=25,thrombolysis in myocardial infarction [TIMI] grade Ⅱ～Ⅲ after IAT) and multi-modal therapy (MMT) group (n=34,onset time longer than 6 h or achieving no good effect afterIAT);their clinical data and follow up data were reviewed and summarized.National Institutes of Health Stroke Scale (NIHSS) was used to evaluate the severity;and modified Rankin scale (mRS) was performed three months after the stroke to reveal the clinical outcomes.The t test,chi-square test and multivariable Logistic regression analysis were performed to analyze the related prognosis factors.Results The mean age of the patients was 59.8±1.3 years.MMT patients had significantly higher baseline admission NIHSS scores as compared with those inIAT patients (18.3±4.2 vs.12.6±4.3,t=l 1.88,P=0.000);MMT patients had a significantly higher patent flow rate as compared withIAT patients (82.4％ vs.56.0％,x2=4.878,P=0.027).Besides,the MMT patients had a significantly longer time till accepting treatment (5.8±1.4 vs.5.3±0.9,t=4.735,P=0.000);In multivariate analysis,age,time getting treatment,NIHSS scores at discharge are predictors for poor outcomes,while perfect recanalization was associated with favorable outcome.Conclusions MMT can be used for patients with severe admission NIHSS scores,and it may enjoy higher patency rate than IAT.Good vessel recanalization is the only predictor for favorable outcome.