Clinical Study of Combined Intravenous and Intra-arterial Thrombolysis for Ultra-acute Cerebral Infarction

Objective To evaluate the efficacy and safety of combined intravenous and intra-arterial thrombolysis for ultra- acute cerebral infarction.Methods 81 patients with acute ischemic stroke of within 6 hours after onset were randomly assigned into two groups, groupⅠ including 46 patients with combined intravenous and intra-arterial thrombolysis and group Ⅱ 35 patients with intra-arterial thrombolysis alone.In groupⅠ,10 000U/kg urokinase were intravenously administered following 5000U/kg urokinase given intra-arterially.While in groupⅡ,10 000/kg urokinase were given intra-arterially alone.The European Stroke Scale (ESS) and Bethel index (BI) were used to evaluate the recovery of neurological deficit function and efficacy and adverse event were observed for all patients in different period.Results ESS scores were 83±24,88±26at 24 hours and 3 days after treatment respectively in groupⅠ,and 77±29,81±24 in groupⅡ2, the BI scores were 71.5±25.9,82.5±27.4 at 3days and 30days after thrombolysis respectively groupⅠ,and 61.5±22.3,72.0±31.6 in groupⅡ,There was significant difference between the two groups(P0.005).The total efficacy rate of groupⅠ86.7% was significantly higher than that of groupⅡ 77.1%,there were 3 patients in group Ⅰ and 2 patients in group Ⅱ with CT hemorrhage after thrombolysis. Conclusion Within 6 hours from onset, combined intravenous and intra-arterial thrombolysis for acute cerebral infarction is more effective than and that of intra-arterial thrombolysis alone. The safety is similar between them.