Analysis of the effectiveness of Enterprise 2 stent implantation in the endovascular recanalization treatment of acute atherosclerotic middle cerebral artery occlusion
Objective To explore the safety and effectiveness of Enterprise 2 stent implantation in the endovascular recanalization treatment of atherosclerotic acute middle cerebral artery(MCA)occlusion.Methods A retrospective analysis was performed on the clinical data of 71 patients with acute ischemic stroke(AIS)caused by atherosclerotic acute MCA occlusion who were admitted to the Neurointerventional Department of Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2019 to December 2022.Among them,46 patients underwent balloon dilation combined with Enterprise 2 stent implantation(stent implantation group),and 25 patients underwent balloon dilation alone(balloon dilation group).The modified Thrombolysis in Cerebral Infarction(mTICI)grade was used to evaluate the degree of postoperative vascular recanalization(mTICI≥grade 2b indicated successful recanalization).Perioperative complications were documented,and the National Institute of Health Stroke Scale(NIHSS)was used to evaluate patients.Neurological function on the 7th day after surgery(NIHSS ≥4 points as compared with pre-operation was considered neurological improvement),and modified Rankin scale score(mRS)was used to evaluate the patient's outcome on the 90th day after surgery(mRS≤2 points indicated good outcome).The presence or absence of vascular restenosis during the follow-up period was assessed by imaging,and the differences between the two groups were compared.Results All 71 patients achieved successful recanalization of blood vessels.Thirty-six cases in the stent implantation group and 17 cases in the balloon dilation group were followed up,and the follow-up time ranged from 3 to 12 months.There were no statistically significant differences between the two groups of patients in terms of age,gender,risk factors related to cerebrovascular disease,whether intravenous thrombolysis was performed,preoperative NIHSS score,whether mechanical thrombectomy was performed,time from onset to femoral artery puncture,or operation duration(all P＞0.05).Compared with the balloon dilatation group,the perioperative distal vessel embolization rate in the stent implantation group[4.3％(2/46)and 20.0％(5/25)respectively],and the incidence rate of in-stent restenosis during the follow-up period(4/36 and 6/17 respectively)were lower(both P＜0.05).There were no statistically significant differences between the two groups in the degree of immediate successful recanalization of blood vessels,the immediate rate of residual stenosis,the incidence of symptomatic intracranial hemorrhage or death within 1 week after surgery,the neurological function improvement rate 1 week after surgery,or the proportion of good outcome 90 days after surgery(all P＞0.05).Conclusion For patients with AIS caused by atherosclerotic acute MCA occlusion,the efficacy of Enterprise 2 stent implantation may be non-inferior to that of simple balloon dilatation,with fewer complications.
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