Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2022; 10(28): 10077-10084
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10077
Endovascular treatment vs drug therapy alone in patients with mild ischemic stroke and large infarct cores
Wen-Hui Kou, Xiao-Qin Wang, Jin-Shui Yang, Nan Qiao, Xiao-Hui Nie, Ai-Mei Yu, Ai-Xia Song, Qian Xue
Wen-Hui Kou, Xiao-Qin Wang, Jin-Shui Yang, Nan Qiao, Xiao-Hui Nie, Ai-Mei Yu, Ai-Xia Song, Qian Xue, Department of Neurology, First Affiliated Hospital of Hebei North University, Zhangjiakou 075061, Hebei Province, China
Author contributions: Kou WH, Wang XQ, Yang JS, Qiao N, Nie XH, Yu AM, Song AX, and Xue Q designed the research study; Kou WH, Wang XQ, and Yang JS performed the research; and all authors have read and approved the final manuscript.
Supported by Scientific Research Fund of Hebei Health Commission 2022, No. 20220591.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of Hebei North University Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ai-Xia Song, MD, Associate Chief Physician, Department of Neurology, First Affiliated Hospital of Hebei North University, No. 12 Changqing Road, Zhangjiakou 075061, Hebei Province, China. 1979958315@qq.com
Received: June 12, 2022
Peer-review started: June 12, 2022
First decision: July 14, 2022
Revised: August 2, 2022
Accepted: August 22, 2022
Article in press: August 22, 2022
Published online: October 6, 2022
Processing time: 107 Days and 1.5 Hours
ARTICLE HIGHLIGHTS
Research background

Endovascular therapy and medical therapy are two major approaches for the treatment of acute ischemic stroke with large vessel occlusion. Comparison of the clinical efficacy and safety of the two approaches is needed.

Research motivation

This study provided evidence for clinicians to better help them make an appropriate treatment decision in the treatment of acute ischemic stroke with large vessel occlusion.

Research objectives

This study aimed to compare the efficacy and safety of endovascular treatment with medical therapy alone in patients with acute ischemic stroke who show a large core infarct.

Research methods

Fifty patients with mild ischemic stroke and 50 patients with large core and occlusion ischemic stroke were enrolled in the study. They were categorized into an endovascular treatment group (28 patients with mild stroke and 22 patients with large infarct cores) and a medical treatment group (22 patients with mild stroke and 28 patients with large infarct cores). Patients in the endovascular treatment group underwent an interventional thrombectomy, and patients in the medical treatment group were treated with alteplase or tirofiban. The National Institutes of Health Stroke Scale scores and short- and long-term prognosis were analyzed in the two groups.

Research results

Significant differences were found in the National Institutes of Health Stroke Scale scores, early deterioration of neurological function, the modified Rankin scale, and the activity of daily living scores between the two groups. However, no significant difference was found in favorable prognosis and mortality between the two groups.

Research conclusions

Patients receiving endovascular treatment had a higher chance of achieving good neurological function compared with those receiving medical therapy.

Research perspectives

This study revealed that neurological function was effectively improved in patients with acute ischemic stroke after endovascular treatment. Endovascular technology evolves at a rapid pace. Future studies should take these new devices and techniques into consideration when investigating endovascular treatment in patients with acute ischemic stroke.