So sánh phương pháp lấy huyết khối trực tiếp với điều trị bắc cầu cho đột quỵ tắc động mạch lớn tuần hoàn trước

From December 2020 to February 2020, 80 patients with acute ischemic stroke caused by anterior large vessel occlusion (AVLO) were recruited for a matched pairs experimental study comparing direct thrombectomy and standard bridging therapy. Patients had a stroke within 4.5 hours, were eligible for intravenous thrombolysis and mechanical thrombectomy (MT) were performed within 6 hours. The baseline parameters of patients were similar between the two groups. At the 90-day follow-up, 25 patients (62.5%) in the direct thrombectomy group versus 24 patients (60%) in the bridging therapy group achieved functional independence (odds ratio [OR] = 0.9, 95% confidence interval [CI]: 0.4 - 2.2, p = 0.82). The successful recanalization rates (Thrombolysis in Cerebral Infarction [TICI] grade 2b to 3) on final angiography were 90% in both groups (OR = 1.0, 95%CI: 0.2 - 4.3, p = 1.00). No significant difference was found between the two groups in the occurrence of symptomatic intracranial hemorrhage or 90-day mortality. Our preliminary results did not show the superiority of direct thrombectomy versus standard bridging therapy in patients with ALVO in the anterior circulation who undergo MT within 4.5 hours. Another multicenter, randomized controlled trial remains necessary to validate these results.