Cao Shan, Dong Hui
Shan Cao, Telemedicine Center, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.
Hui Dong, Department of Emergency, Baoding No.1 Central Hospital, Baoding, 071000, Hebei, China.
Pak J Med Sci. 2021 Mar-Apr;37(2):466-471. doi: 10.12669/pjms.37.2.3293.
To investigate the efficacy and safety of endovascular treatment in patients having acute ischemic stroke with over-time window under DWI-FLAIR mismatch.
From January 2018 to January 2020, 80 patients who met the research criteria in the First Central Hospital of Baoding, China were selected. According to the time of onset, they were divided into test group and control group, with 40 cases in each group. Forty patients in the test group were beyond time window (6~24h) and the MRI showed a DWI-FLAIR mismatch. Forty patients in the control group were within the time window (< 6h). All patients received endovascular treatment (EVT). The mRS, NIHSS and infarct volume of patients in the test group were compared and analyzed before and 30 and 90 days after treatment, as well as the indicators of both groups of patients before and after treatment, to determine therapeutic effect in patients receiving EVT beyond time window. Meanwhile, the recanalization of the blood vessel and the incidence of cerebral hemorrhage of patients in both groups were compared to determine the safety in patients receiving EVT beyond time window under DWI-FLAIR mismatch.
The mRS, NIHSS and infarct size in the test group were significantly improved before and 30 and 90 days after treatment (p<0.05). The test group showed no significant difference in mRS, NIHSS and other indicators when compared with the control group (p>0.05). There was no significant difference in the rate of recanalization of the blood vessel and intracranial hemorrhage after treatment between both groups (p>0.05).
DWI-FLAIR mismatch can be used as an objective imaging basis for intravascular interventional therapy in patients with stroke with over-time window and large vessel occlusion. It has the advantages of short examination time, non-invasiveness, no need for contrast agents, simple implementation, clear guidance.
探讨血管内治疗对DWI-FLAIR不匹配的超时间窗急性缺血性脑卒中患者的疗效及安全性。
选取2018年1月至2020年1月在中国保定市第一中心医院符合研究标准的80例患者。根据发病时间分为试验组和对照组，每组40例。试验组40例患者超出时间窗（6~24小时）且MRI显示DWI-FLAIR不匹配。对照组40例患者在时间窗内（<6小时）。所有患者均接受血管内治疗（EVT）。比较分析试验组患者治疗前、治疗后30天和90天的改良Rankin量表（mRS）、美国国立卫生研究院卒中量表（NIHSS）及梗死体积，以及两组患者治疗前后的各项指标，以确定超时间窗患者接受EVT的治疗效果。同时，比较两组患者血管再通情况及脑出血发生率，以确定DWI-FLAIR不匹配的超时间窗患者接受EVT的安全性。
试验组治疗前、治疗后30天和90天的mRS、NIHSS及梗死面积均显著改善（p<0.05）。试验组与对照组相比，mRS、NIHSS等指标差异无统计学意义（p>0.05）。两组治疗后血管再通率及颅内出血情况差异无统计学意义（p>0.05）。
DWI-FLAIR不匹配可作为超时间窗且存在大血管闭塞的脑卒中患者血管内介入治疗的客观影像学依据。其具有检查时间短、无创、无需造影剂、操作简单、指导明确等优点。
