Association of stent thrombectomy and conventional treatment with neuroprotection, complications, anxiety, and depression in acute ischemic stroke patients

Abstract

BACKGROUND

Acute ischemic stroke (AIS) is an abrupt blood flow cessation to a specific brain region within a vascular zone, causing a subsequent decline in neurological capabilities. Stent thrombectomy is a recently established technique for treating AIS. It provides the benefits of being a relatively simple and safe procedure, capable of partially enhancing a patient’s condition. However, some patients may experience endothelial damage and recurrent thrombosis, with clinical outcomes that are not always satisfactory. Hence, the efficacy of this method remains unclear.

AIM

To survey the association of stent thrombectomy vs standard treatment with neurological function protection, complications, and short-term prognosis in patients diagnosed with AIS.

METHODS

This study assigned 90 patients with AIS to the observation and control groups (n = 45 patients) from December 2020 to December 2022. Stent thrombectomy was conducted in the observation group, whereas routine treatment was provided to the control group. The study assessed the therapeutic outcomes of two groups, including a comparison of their neurological function, living ability, anxiety and depression status, plaque area, serum inflammatory factors, serum Smur100 β protein, neuron-specific enolase (NSE), homocysteine (Hcy), and vascular endothelial function. Additionally, the incidence of complications was calculated and analyzed for each group.

RESULTS

The total effective rate of treatment was 77.78% and 95.56% in the control and observation groups, respectively. After 8 weeks of treatment, the scores on the National Institutes of Health Stroke Scale, Hamilton Anxiety Scale, and Hamilton Depression Scale decreased remarkably; the Barthel index increased remarkably, with better improvement effects of the scores in the observation group (P < 0.05); total cholesterol, triglyceride, C-reactive protein, and plaque area lessened remarkably, with fewer patients in the observation group (P < 0.05); S-100β protein, NSE, and Hcy levels lessened remarkably, with fewer patients in the observation group (P < 0.05); serum vascular endothelial growth factor and nitric oxide synthase levels increased remarkably, whereas the endothelin-1 level decreased, with better improvement effect in the observation group (P < 0.05). Complications occurred in 8.88% of patients in the observation group compared with 33.33% in the control group.

CONCLUSION

Stent thrombectomy appeared to provide more remarkable neuroprotective effects in patients with AIS compared to the intravenous thrombolysis regimen. Additionally, it has effectively improved the neurological function, daily activities, and vascular endothelial function of patients, while reducing the incidence of complications and improving short-term prognosis.

Keywords: Stent thrombectomy; Acute ischemic stroke; Neurological function; Complications; Short-term prognosis

Core Tip: Acute ischemic stroke (AIS) disrupts blood flow within the blood supply area of the local brain tissue, which causes ischemic necrosis of the affected brain tissue. Stent thrombectomy is a novel treatment with medicine and material science development in recent years, and it demonstrates a good effect in acute cerebral infarction treatment. This study aims to confirm the association of stent thrombectomy with neurological protection, complications, and short-term prognosis in patients with AIS.