Comparison of Intravenous Thrombolytic Effect of Acute Ischemic Stroke Patients with Different Large Vessel Occlusion

Objective To compare the intravenous thrombolytic therapeutic effect of the acute ischemic stroke patients with different large vessel occlusion and to investigate which occlusion subtype of patients are suitable for intravenous thrombolytic treatment.Methods Data were analyzed from the Thrombolysis Implementation and Monitoring of Acute Ischemic Stroke in China(TIMS-China). Patients who accomplished multiple parameter computed tomography(CT) or magnetic resonance(MR) and CT angiography or MR angiography showed large vessel occlusion were included. The safety and efficacy outcome were compared.Results A total of 122 patients were included. The rates of recanalization were:middle cerebral artery(MCA) occlusion group 55.2%, internal carotid artery(ICA) occlusion group 0% and basilar artery(BA) occlusion group 40%. For the functional independence outcome at 90 days, MCA occlusion group was significantly better than ICA occlusion group(53.9% vs 21.1%, P=0.007, [odds ratio, OR]=5.68). For excellent recovery outcome at 90 days, MCA occlusion group was also significantly better than ICA occlusion group(42.7% vs 21.1%, P=0.041, OR=3.76). For mortality, MCA group was significantly lower than ICA group(4.5% vs 47.4%, P0.001, OR=0.03). There were no significant differences between MCA group and ICA group in the symptomatic intracranial hemorrhage(1.1% vs 0%, P=0.962).Conclusion The intravenous thrombolytic therapeutic effect of the acute ischemic stroke patients with different large vessel occlusion was significantly different. The recanalization rate of MCA occlusion group was highest, and the therapeutic effect was significantly better than ICA occlusion group.