Long-term outcome of intra-arterial thrombolysis for acute Ischemic stroke and its influencing factors.

Objective To investigate the long-term outcome of intra-arterial thrombolysis in patients with acute ischemic stroke and its influencing factors. Methods Patients with acute ischemic stroke who received intra-ar- terial thrombolysis were selected for this study. The neurological function was assessed by using the modified Rankin Scale(mRS). Patients scored 0~2 were divided into the good outcome group, and patients scored 3~6 were divided in- to the poor outcome group. The degree of recanalization after thrombolysis was assessed by the grading criteria of the Thrombolysis in Myocardial Infarction(TIMI) trial, the incidence of intracerebral hemorrhage within 7 days after thrombolytic therapy was observed. Univariate analysis and multivariate logistic regression analysis were used to screen the influencing factors of long-term outcome of arterial thrombolysis. Results In the all 80 patients who re- ceived intra-arterial thrombolysis, 75 patients have finished the research, including 36 patients(48.0%) with good out- come and 39 patients(52.0%) with poor outcome after intra-arterial thrombolysis. Forty-eighit patients(64.0%) had good recanalization(TIMI grade, 2~3), and 23 patients(30.7%) occurred intracranial hemorrhage within 7 days. The baseline blood glucose levels(P=0.009), the baseline National Institutes of Health Stroke Scale(NIHSS) scores(P=0.001), the degree of recanalization(P=0.002) and symptomatic intracranial hemorrhage(P=0.001) could influence the long term out- come of patients with intra-arterial thrombolysis. The lower level of baseline glucose(P=0.033) and good recanalization(P= 0.006) were the independent predictive factors of the good long-term outcome. Conclusion In certain conditions, it is safe and effective to receive intra-arterial thrombolysis for the patients with acute ischemic stroke. The baseline blood glucose levels and the degree of recanalization are the independent predictive factors of the long-term outcome.