Efficacy of intravascular mechanical thrombectomy combined with thrombolysis and anticoagulant therapy in the treatment of cerebral venous sinus thrombosis and its effect on neurological function and coagulation indices

摘要

Objective: To evaluate the efficacy of Solitaire AB stent mechanical thrombectomy combined with thrombolysis and anticoagulant therapy (AT) in the treatment of cerebral venous sinus thrombosis (CVST) and its effect on neurological function and coagulation indices. Methods: Eighty-two patients with CVST were randomly divided into two groups according to the random number table method. The control group (n=41) were treated with arteriovenous thrombolysis combined with AT, and the observation group were treated with intravascular mechanical thrombectomy plus thrombolysis combined with AT. The effect of the treatment was evaluated 7 days after treatment, and a 6-month follow-up was conductedz after the course of treatment. The clinical efficacy, neurological function (National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS)), coagulation function, complications and prognosis were compared between the two groups. Results: The continuous improvement rate of clinical symptoms 7 days after treatment in the observation group (87.80%) was higher than that in the control group (58.54%) (P0.01); The neurological function scores of both groups after treatment were lower than those before treatment (all P0.001); The scores of NIHSS and mRS in the observation group were lower than those in the control group 7 days after treatment (all P0.001). The coagulation indices of fibrinogen (FIB), prothrombin time (PT) and activated partial thromboplastin time (APTT) of 7 days after treatment in the observation group were shorter than those in the control group (all P0.001), and the D-Dimer (D-D) level in the observation group was higher than that in the control group (P0.001). The incidences of intracranial hemorrhage, infection, headache, quadriplegia, dizziness and drowsiness in the observation group were lower than those in the control group (all P0.05). The recanalization rate of venous sinus in the observation group was higher than that in the control group 6 months after treatment (P0.01). Conclusion: Intravascular mechanical thrombectomy plus thrombolysis combined with AT for patients with CVST is effective, which can effectively improve the coagulation function and promote the recovery of neurological function, with fewer complications and a good prognosis.