Interventional therapy for rapid stroke treatment

  Cerebrovascular disease is a common and frequent disease that endangers human life and health, and is characterized by high prevalence, high recurrence rate, high disability rate and high mortality rate, ranking among the top three causes of human death, and is one of the most dangerous factors affecting people’s health and one of the most concerned health problems in the field of public health.  The Interventional Department of Weifang Hospital of Traditional Chinese Medicine has successfully carried out arterial thrombolysis and stentoplasty in the “green channel for stroke”. For patients who have had acute cerebral infarction, “time is brain”, and they must generally receive timely and correct treatment within 6 hours after the onset of the disease; otherwise, it will be difficult to treat and have a high disability rate or even death if it is delayed for a long time.  Early intra-arterial thrombolytic therapy is performed by puncturing the catheter through the blood vessel at the root of the thigh, and then directly injecting thrombolytic drugs into the vicinity of the thrombus after reaching the site of infarction. This method uses small doses of drugs, high concentration of drugs around the thrombus, exact thrombolytic effect, high rate of revascularization, up to 60-70%, compared with intravenous thrombolysis, the mortality rate of patients can be reduced by 1/3. With conventional drugs for cerebral infarction, only 25% of patients recover completely or have minor disabilities that do not affect their lives, and intravenous thrombolysis can increase this rate to 41% at 3 months, while arterial thrombolysis makes it as high as 70-80%. 80%. Although thrombolysis is effective, less than 3-5% of patients currently receive thrombolysis, mainly because patients delay their hospital visits beyond the time window for thrombolysis.  The so-called “time window” is the time interval between the onset of the disease and thrombolysis, and thrombolysis is more effective only within this time period; if it is longer than this time, the effect of thrombolysis will become worse and the side effects of bleeding will increase, which is not worth the loss. It is generally believed that the time window for intravenous thrombolysis is 3-6 hours, and the time window for arterial thrombolysis is 6 hours for anterior circulation and 72 hours for posterior circulation.  Therefore, it is recommended that patients should go to the hospital immediately once the onset of the disease, and perform thrombolytic therapy as soon as possible, preferably intravenous thrombolysis if available, and stenting can be performed directly if stenosis is found at the same time as arterial thrombolysis.  Cerebrovascular stenting is a kind of preventive treatment, the main purpose of which is to improve cerebral blood supply and reduce the chance of recurrence of cerebral infarction in the future. Among the cerebrovascular diseases, there is a kind of cerebrovascular disease called ischemic cerebrovascular disease, which is mostly caused by atherosclerosis of the internal carotid arteries, forming atheromatous plaques and gradually blocking the lumen of the blood vessels. Carotid artery stenting mainly treats high levels of carotid stenosis.  To restore the internal diameter of the lumen, an effective treatment is to place a highly elastic spring ring in the lumen to hold the stenosis open. Carotid stents are made of nickel-titanium alloy, an alloy material with memory capacity, which can change its shape arbitrarily at lower temperatures outside the body; once exposed to the temperature of blood flow, the stent remains open, maintaining a certain tension on the vessel wall and not being deflated under external forces.  Since the surface of the metal is specially treated, long-term implantation in the blood vessel does not produce any damage to the surrounding tissues, which means that it is highly biologically tolerable.  The procedure does not require an incision, but simply involves local anesthesia in the femoral artery, insertion of the catheter, up through the aorta, placement of the catheter into the carotid artery, balloon dilation of the stenosis with a balloon, and placement of the catheter with the stent into the internal carotid artery stenosis, also through the femoral artery; then the stent is released, the position is determined, and finally all catheters are withdrawn, and the procedure is completed. The entire procedure takes only half an hour to an hour, and the patient is awake throughout the procedure without significant pain.