Objective To investigate the clinical effect of Solitaire stent retriever combined with intravenous thrombolysis using alteplase in the treatment of acute large vessel occlusive cerebral infarction.
Methods A total of 86 patients with acute large vessel occlusive cerebral infarction were prospectively selected as the study subjects. They were randomly divided into observation group and control group using a random number table method, with 43 cases in each group. The control group received intravenous thrombolysis with alteplase, while the observation group received Solitaire stent retriever combined with the treatment in the control group. The therapeutic efficacy, thrombectomy effect, neurological function National Institutes of Health Stroke Scale (NIHSS) score, modified Rankin Scale (mRS) score, coagulation function fibrinogen (FIB), thrombin time (TT), prothrombin time (PT), and the occurrence of complications were compared between the two groups.
Results The therapeutic effective rate in the observation group was 93.02%, which was higher than 74.42% in the control group, and the difference was statistically significant (P < 0.05). There was no significant difference in the Thrombolysis in Cerebral Infarction (TICI) grade and the rate of vascular recanalization between the two groups (P>0.05). The number of thrombectomy attempts and the thrombectomy time in the observation group were less or shorter than those in the control group, and the differences were statistically significant (P < 0.05). After treatment, the NIHSS and mRS scores in both groups were lower than those before treatment, and the scores in the observation group were lower than those in the control group, with statistically significant differences (P < 0.05). After treatment, the FIB levels in both groups were lower than those before treatment, while the TT and PT were longer than those before treatment. Moreover, the FIB level in the observation group was lower than that in the control group, and the TT and PT were longer than those in the control group, with statistically significant differences (P < 0.05). There was no significant difference in the overall incidence of complications between the two groups (P>0.05).
Conclusion Solitaire stent retriever combined with intravenous thrombolysis using alteplase has significant advantages in the treatment of acute large vessel occlusive cerebral infarction. It can improve the therapeutic effective rate, enhance neurological and coagulation functions, and has good safety.