Long-term outcome of intra-arterial thrombolysis for acute ischemic stroke and its influencing factors a retrospective case series study

Objective To investigate the long-term outcome of intra-arterial thrombolysis in patients with acute ischemic stroke and its influencing factors. Methods Patients with acute ischemic stroke received intra-arterial thrombolysis were included in the study. The neurological outcome at day 90 was assessed using the modified Rankin Scale （mRS）. They were divided into the good outcome group （mRS scores, 0 to 2） and the poor outcome group （mRS scores, 3 to 6） according to the evaluation results; the degree of recanalization after thrombolysis was assessed by the grading criteria of the Thrombolysis in Myocardial Infarction （TIMI） trial; the incidence of intracerebral hemorrhage within 7 days after thrombolytic therapy and the mortality at 3 months were recorded. Univariate analysis and multivariate logistic regression analysis were used to screen the influencing factors of long-term outcome of arterial thrombolysis. Results A total of 42 patients were included, of them, 19 （45.2%） with good outcome and 23 （54. 8%） with poor outcome after intra-arterial thrombolysis; 27 patients （64. 5%） with good recanalization （TIMI grade, 2 to 3）; 13 patients （31.0%） occurred intracranial hemorrhage within 7 days, and 8 of them （19. 0%） had symptomatic intracranial hemorrhage; 11 （26. 2%） died within 90 days. Univariate analysis showed that the baseline blood glucose levels （P = 0. 019）, the baseline National Institutes of Health Stroke Scale （NIHSS） scores （P = 0. 014）, symptomatic intracranial hemorrhage （P = 0. 005）, and the degree of recanalization （P = 0. 002） could influence the longterm outcome of patients with intra-arterial thrombolysis. Multivariate logistic regression analysis indicated that the lower level of baseline glucose and good reeanalization were the independent predictive factors of the good long-term outcome after intra-arterial thrombolysis in patients with acute isehemic stroke. Conclusion After the exclusion of contraindieations, the intra-arterial thrombolysis was safe and effective for patients with acute ischemic stroke. The lower blood glucose levels on admission and the good recanalization after thrombolysis were associated with the good long-term outcome of intra-arterial thrombolysis. Key words: Stroke;  Brain ischemia;  Thrombolytic therapy;  Fibrinolytic agents;  Urokinase;  Tissue plasminogen activator;  Treatment outcome;  influential factors