1. Quantitative analysis of thrombus migration before mechanical thrombectomy: Determinants and relationship with procedural and clinical outcomes
- Author
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Magni Christophe, Boulouis Grégoire, Cottier Jean-Philippe, Bibi Richard, Dejobert Maëlle, Cohen Clara, Narata Ana-Paula, Gaillot Kathleen, Ifergan Héloïse, Molinier Elisabeth, Amelot Aymeric, Gaudron Marie, and Janot Kévin
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Vessel origin ,Brain Ischemia ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,Thrombus ,Acute ischemic stroke ,Aged ,Ischemic Stroke ,Retrospective Studies ,Thrombectomy ,Aged, 80 and over ,Radiological and Ultrasound Technology ,business.industry ,Thrombosis ,Mean age ,Thrombolysis ,Middle Aged ,medicine.disease ,Stroke ,Mechanical thrombectomy ,Treatment Outcome ,Cardiology ,Female ,Neurology (clinical) ,business ,Large vessel occlusion - Abstract
BACKGROUND AND PURPOSE In patients with acute ischemic stroke (AIS) and a large vessel occlusion (LVO), thrombus migration (T-Mig) is a common phenomenon before mechanical thrombectomy (MT), revealed by pre-treatment imaging. Previous works have used qualitative scales to define T-Mig. The aim of this study was to evaluate the determinants and impact of quantitatively assessed T-Mig on procedural characteristics and clinical outcome. METHODS Consecutive patients with AIS due to LVO treated by MT at a reference academic hospital were analysed. Distance between vessel origin and beginning of the thrombus on MRI (3D-time-of-flight and/or contrast-enhanced magnetic-resonance-angiography) and digital-substracted-angiography (DSA) were measured in millimeters using a curve tool. Thrombus migration was defined quantitatively as ∆TD calculated as the difference between pre-MT-DSA and MRI thrombus location. ∆TD was rated as significant if above 5mm. RESULTS A total of 267 patients were included (mean age 70±12 years; 46% females) were analyzed. Amongst them, 65 (24.3%) experienced any degree of T-Mig. T-Mig was found to be associated with iv-tPA administration prior to thrombectomy (β-estimate 2.52; 95% CI [1.25-3.79]; p
- Published
- 2022
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