Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10077
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
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.
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.
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.
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.
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.
Patients receiving endovascular treatment had a higher chance of achieving good neurological function compared with those receiving medical therapy.
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.