Abstract: Objective To investigate the therapeutic effects of direct endovascular therapy (DEVT) and bridging therapy (BT) on patients with acute large vessel occlusion cerebral infarction and their impact on prognosis. 
Methods A prospective randomized study was conducted to select 120 patients with acute large vessel occlusion cerebral infarction and divide them into DEVT group (n=60) and BT group (n=60) according to random number table method. DEVT group was given DEVT, and BT group was given BT. The scores of the National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI), and modified Rankin score (mRs) were observed before and after treatment in both groups. In the meantime, serum brain derived neurotrophic factor (BDNF), nerve specific enolase (NSE), insulin-like growth factor-1 (IGF-1), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), endothelin-1 (ET-1), nitric oxide (NO) and calcitonin gene-related peptide (CGRP) levels were detected in the two groups. 
Results There was no significant difference in the proportion of patients with mRS score ≤ 2 between two groups (P＞0.05). At one week after treatment, the NIHSS score and NSE in the two groups were significantly lower than those before treatment, while the levels of BDNF and IGF-1 were higher than those before treatment. The NIHSS score and NSE in the BT group were significantly lower than those in the DEVT group, while the BDNF and IGF-1 were significantly higher than those in the DEVT group (P＜0.05). At 24 h after treatment, the levels of hs-CRP, TNF-α, and ET-1 in the two groups were lower than those before treatment, while the levels of NO and CGRP were higher than those before treatment. The levels of ET-1 in the BT group were lower than those in the DEVT group, while the levels of NO and CGRP were higher than those in the DEVT group (P＜0.05). 
Conclusion Both DEVT and BT regimens have significant effects in the treatment of patients with acute large vessel occlusion cerebral infarction. BT regimens are more conducive to the recovery of neurological function and improvement of vascular endothelial function.  

Key words: brain infarction, direct endovascular therapy, bridging therapy