دورية أكاديمية

Association between clot composition and stroke origin in mechanical thrombectomy patients: analysis of the Stroke Thromboembolism Registry of Imaging and Pathology

التفاصيل البيبلوغرافية
العنوان: Association between clot composition and stroke origin in mechanical thrombectomy patients: analysis of the Stroke Thromboembolism Registry of Imaging and Pathology
المؤلفون: Brinjikji, Waleed, Nogueira, Raul G, Kvamme, Peter, Layton, Kennith F, Delgado Almandoz, Josser E, Hanel, Ricardo A, Mendes Pereira, Vitor, Almekhlafi, Mohammed A, Yoo, Albert J, Jahromi, Babak S, Gounis, Matthew J, Patel, Biraj, Abbasi, Mehdi, Fitzgerald, Seán, Mereuta, Oana Madalina, Dai, Daying, Kadirvel, Ramanathan, Doyle, Karen, Savastano, Luis, Cloft, Harry J, Haussen, Diogo C, Al-Bayati, Alhamza R, Mohammaden, Mahmoud H, Pisani, Leonardo, Rodrigues, Gabriel Martins, Thacker, Ike C, Kayan, Yasha, Copelan, Alexander, Aghaebrahim, Amin, Sauvageau, Eric, Demchuk, Andrew M, Bhuva, Parita, Soomro, Jazba, Nazari, Pouya, Cantrell, Donald Robert, Puri, Ajit S, Entwistle, John, Polley, Eric C, Kallmes, David F
المساهمون: National institute of health
المصدر: Journal of NeuroInterventional Surgery ; volume 13, issue 7, page 594-598 ; ISSN 1759-8478 1759-8486
بيانات النشر: BMJ
سنة النشر: 2021
الوصف: Background We retrospectively evaluated the composition of retrieved clots from ischemic stroke patients to study the association between histological composition and stroke etiology Methods Consecutive patients enrolled in the Stroke Thromboembolism Registry of Imaging and Pathology (STRIP) were included in this study. All patients underwent mechanical thrombectomy and retrieved clots were sent to a central core lab for processing. Histological analysis was performed using martius scarlet blue (MSB) staining, and quantification for red blood cells (RBCs), white blood cells (WBCs), fibrin and platelets was performed using Orbit Image Software. A Wilcoxon test was used for continuous variables and χ 2 test for categorical variables. Results 1350 patients were included in this study. The overall rate of Thrombolysis In Cerebral Infarction (TICI) 2c/3 was 68%. 501 patients received tissue plasminogen activator (tPA) (37%). 267 patients (20%) had a large artery atherosclerosis (LAA) source, 662 (49%) a cardioembolic (CE) source, 301 (22%) were cryptogenic, and the remainder had other identifiable sources including hypercoagulable state or dissection. LAA thrombi had a higher mean RBC density (46±23% vs 42±22%, p=0.01) and a lower platelet density (24±18% vs 27±18%, p=0.03) than CE thrombi. Clots from dissection patients had the highest mean RBC density (50±24%) while clots from patients with a hypercoagulable state had the lowest mean RBC density (26±21%). Conclusions Our study found statistically significant but clinically insignificant differences between clots of CE and LAA etiologies. Future studies should emphasize molecular, proteomic and immunohistochemical characteristics to determine links between clot composition and etiology.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1136/neurintsurg-2020-017167
الإتاحة: https://doi.org/10.1136/neurintsurg-2020-017167Test
رقم الانضمام: edsbas.71779CFE
قاعدة البيانات: BASE