Clinical study on the effects of over time window thrombectomy and thrombolytic therapy on granulocyte colony-stimulating factor expression and postoperative brain function after acute cerebral infarction.

Abstract

Objective: This study aimed to explore the effects of thrombectomy and thrombolytic therapy beyond the standard time window on granulocyte colony-stimulating factor (G-CSF) expression and postoperative brain function in patients with acute cerebral infarction.

Methods: Sixty patients with acute cerebral infarction, who met the defined time window criteria, were randomly assigned to either the observation group (n = 30) or the control group (n = 30). The observation group underwent thrombectomy using the TREVO stent, while the control group received intravenous thrombolysis with rt-PA, a human tissue plasminogen activator. Comparative analyses between the two groups focused on G-CSF levels, NIHSS scores, MoCA scores, and the modified thrombolysis in cerebral infarction (mTICI) scale. Multivariate linear regression was performed to adjust for confounding factors including age, sex, and comorbidities. The Pearson correlation method was employed to assess the correlation between post-thrombectomy outcomes and G-CSF expression, as well as the impact on postoperative brain function.

Results: At 72 h and 90 days post-procedure, both groups demonstrated an increase in G-CSF levels and MoCA scores, accompanied by a decrease in NIHSS scores. Notably, the observation group exhibited significantly higher G-CSF levels and MoCA scores compared to the control group, alongside significantly lower NIHSS scores (P < 0.05). Multivariate analysis confirmed the treatment group as an independent predictor of improved outcomes (P < 0.05). The rate of successful vascular recanalization was substantially higher in the observation group (90.00%) compared to the control group (56.67%). There was a significant positive correlation between NIHSS scores, MoCA scores, mTICI, and post-thrombectomy G-CSF expression (P < 0.05).

Conclusion: In patients with acute cerebral infarction beyond the conventional time window, the use of TREVO stent thrombectomy and recanalization is effective, resulting in marked improvements in cognitive function. Moreover, G-CSF appears to play a critical role in the pathophysiology of acute cerebral infarction, establishing a strong association between G-CSF expression and postoperative brain function in affected individuals.