Clinical study of combined intravenous and intra-arterial thrombolysis for acute ischemic stroke

Objective To evaluate the efficacy and safety of combined intravenous and intra-arterial thrombolysis for acute ischemic stroke. Methods 65 patients with acute ischemic stroke of within 6 hours after onset were randomly assigned into two groups. 35 cases were treated with combined superselective intravenous and intra-arterial thrombolysis, while 30 with intra-arterial thrombolysis (IAT) alone. In IAT alone group, 500 000～1 500 000U urokinase were administered. While in combined treatment group, 5 000～10 000U/kg urokinase were given intravenously, followed by IAT. The total amount of Urokinase was no more than 1500 000U for each patient. The European Stroke Scale (ESS) was used to evaluate the recovery of neurological function for all patients. Results ESS scores were 83 ± 24, 88 ± 26 at 24 hours and 30 days after treatment respectively in combined treatment group, and 77 ± 29, 81 ± 24 in IAT alone group at the same timing. There was significant difference between the two groups(P 0.05). The total recanalization rate of combined treatment group (42.8%) was significantly higher than that of IAT alone group (33.3%). Conclusion Treatment of combined superselective intravenous and intra-arterial thrombolysis for acute ischemic stroke is more effectively than that of local intra-arterial thrombolysis alone,and is safely.