Search

Introduction. A better thrombus characterization could be useful to determine acute ischemic stroke (AIS) etiology, and predict response to thrombolysis and endovascular therapy (EVT). To test the hypothesis that the presence of the susceptibility vessel sign (SVS) on baseline MRI is related to the quantitative red blood cells (RBC) content of thrombi from EVT-treated AIS patients, we compared the total hemoglobin content of these thrombi according to the presence of a SVS or two-layered SVS (TLSVS). Method. Baseline MRI of 84 anterior AIS patients were reviewed by neuro-radiologists blinded to clinical and biochemical data. Thrombi retrieved during EVT underwent biochemical analysis on their homogenate. Hemoglobin content (HbC) was measured by two different methods, an ELISA-based method and the quantification of heme content. Results. SVS and TLSVS were respectively observed in 85.7% and 50.0% of cases. The median ELISA-based HbC was 253 u00b5g/mg (IQR, 177 to 333) and the median heme content was 219 u00b5g/mg (131 to 264). A perfect correlation between these 2 methods was found (r=0.958, 95%CI, 0.936 to 0.973). Patients with TLSVS had a higher weight of retrieved thrombi (31.1 [16.5 to 68.3] vs. 17.7 [11.7 to 33.3]; p=0.005) and a higher HbC (278 [221 to 331] vs. 196 [139 to 301]; p=0.010) than patients without TLSVS. Biochemical characteristics of thrombi did not differ significantly according to SVS status. Interpretation. Our study shows for the first time according to 2 biochemical quantitative assessments that TLSVS was significantly associated with a higher thrombus weight and RBC content.