Analysis of Therapeutic Time Window and Effect in Acute Cerebral Infarction Treated with Intra-arterial Thrombolytic Therapy

Objective To investigate the relation between the therapeutic effect and time window in local intra-arterial thrombolysis for acute cerebral infarction.Materials and Methods 245 patients with acute ischemic cerebral stroke examined by CT and angiography were treated by intra-arterial thrombolysis.56 cases were treated by thrombolysis within 6 hours from onset of stroke,189 cases were treated by intra-arterial thrombolysis between 6 to 24 hours.The recanalization rate and clinical outcome for 90 days in two groups were evaluated.Results Angiography showed occlusion of the cerebral artery in 245 patients,among them,173 patients showed the occlusion in the internal carotid artery(ICA)system,72 patients in the vertebrobasilar artery(VBA)system,successful recanalization was achieved in 150 patients(113 patients in ICA and 37 patients in VBA).Followed up for 90 days,180 patients had a good outcome,65 had poor prognosis.12 patients were associated with intracranial hemorrhage.Good prognosis rate of 6h group and 6-24h group was 80.35%(45/56)and 71.43%(135/189)respectively,the recanalization rate of two groups was 66.07%(37/56)and 59.79%(113/189),the mean time of occluded artery recanalization was 67min and 73min respectively.Conclusion Successful recanalization of cerebral occlusive artery by using intra-arterial thrombolysis could improve clinical prognosis in patients with acute ischemic cerebral stroke.It is not enough to limited therapeutic time window within 6 hours,some cases with cerebral infarction after 6 hours of stroke onset can benefit from intra-arterial thrombolytic therapy.