Endovascular Interventional Thrombolysis Combined With Mild Hypothermia Induced by Intravascular Hypothermia Saline Fails to Improve Outcomes in the Acute Large Vessel Occlusive Cerebral Infarction Patients: A Single-Center Prospective Case-Control Study.

Abstract

Background: The mild hypothermia for thrombolysis in patients with cerebral infarction caused by acute large-vessel occlusion is superior to the standard medical treatment.

Aims: The safety and effectiveness of cytoprotection and prognosis from the hypothermia is under investigation.

Methods: Twenty-five patients with acute occlusion of intracranial large vessels treated with endovascular thrombolysis of hypothermic saline infusion within 24 h at the onset of the disease were enrolled as a treatment group. As a control group, 166 patients suffering from acute large-vessel occlusion and infused with normal temperature saline at the hospital during the same period were selected. The patients were paired according to gender, age, pathogenesis, offending vessel, risk factors, and combined underlying diseases. The baseline data were recorded and compared between the two groups. The pre- and postprocedure contents and prognosis of patients were recorded and compared for safety assessment.

Results: Twenty pairs of patients were rigorously matched into the final statistical analysis. There was a significant decrease in the hematocrit difference of treatment group compared with the control group. However, we found no significant differences between the two groups regarding 7-day postoperative NIHSS scores, incidence of pneumonia, rate of CT abnormalities in the immediate postoperative period, the rate of 7-day postoperative head CT hemorrhage, the occurrence of severe cerebral edema, and 90-day postoperative mRS scores.

Conclusions: Targeted intravascular subcryogenic temperature combined with arterial thrombolysis is safe for the treatment of large-vessel occlusive cerebral infarction, but the treatment fails to improve outcomes in the acute large vessel occlusive cerebral infarction patients.