Comparison of the efficacy between early endovascular intervention and thrombolytic therapy in cerebral ischemic stroke

Chen Yuheng; Zou Wenjing

doi:10.11850/j.issn.1009-122X.2025.04.005

Abstract：Objective To compare the clinical efficacy of early endovascular intervention versus intravenous thrombolytic therapy alone in the treatment of cerebral ischemic stroke(CIS).Methods Clinical data of 112 patients with ICS were analyzed retrospectively.According to different treatment methods,the patients were divided into control group(58 cases)and intervention group(54 cases).The control group received intravenous thrombolytic therapy with alteplase,while the intervention group received mechanical thrombectomy in addition to the treatment given to the control group.The National Institutes of Health Stroke Scale(NIHSS)score,Barthel Index(BI)score,vascular recanalization rate,levels of biochemical indicators including malondialdehyde(MDA),norepinephrine(NE)and myelin basic protein(MBP),neuronal injury factors including neuron-specific enolase(NSE),S100 calcium binding protein β(S100β)and matrix metalloproteinase-9(MMP-9)],cerebral blood perfusion including cerebral blood volume(CBV)and cerebral blood flow(CBF),and adverse reactions were compared between the two groups before and after treatment.Results After treatment,the NIHSS score in the intervention group was lower than that in the control group,while the BI score and vascular recanalization rate were higher,with all differences being statistically significant(all P<0.05).The levels of MDA,NE,MBP,NSE,S100β,and MMP-9 in the intervention group were lower than those in the control group after treatment,while the levels of CBV and CBF were higher,with all differences being statistically significant(all P<0.05).There was no significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusions Early endovascular intervention in patients with CIS can help reduce oxidative stress and neuro-injury,improve vascular recanalization rate,increase cerebral blood perfusion,and promote the recovery of neurological function and daily living abilities,and moreover it is a safe and feasible treatment option.