Our experience in using of intravascular recanalization methods for treatment of acute ischemic stroke

Abstract

Objective ‒ to evaluate results of the introduction of intravascular recanalization in the provision of emergency care to patients with ischemic stroke.
Materials and methods. The experience of intraarterial thrombolysis on the example of 25 clinical cases was analysed. In 22 patients was performed selective intra-arterial thrombolysis, in 3 cases ‒ with thrombaspiration. All patients had a severe stroke, ranging from 15 to 25 points NIHSS. Confirmation of the diagnosis was performed according to computed tomography scan), ultrasound of the precerebral and cerebral arteries. Selective cerebral angiography was performed up to 6 hours after the onset of stroke. Patients were infused with 3 ml of recombinant tissue plasminogen activator bolus into the occluded vessel, followed by infusion at a dose of up to 20 ml for 1 hour, in 2 cases ‒ internal carotid artery stenting. Outcomes were assessed according to computed tomography, NIHSS and a modified Rankin scale for 30 days.
Results. The combination of methods of intra-arterial thrombolysis and stenting of the internal carotid artery made it possible to minimized the negative consequences with sufficient restoration of the arterial lumen, which was controlled with digital subtraction angiography.
Conclusions. Intravascular thrombectomy is the most promising and actively develo-ping area of ​​interventional treatment of ischemic stroke. Indication for selective intraarterial infusion of thrombolytics is the presence of acute cerebral circulatory disorders of the ischemic type in the middle cerebral artery pool when it is impossible to conduct mechanical thrombextraction.