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Fibrin Clot Architecture in Acute Ischemic Stroke Treated With Mechanical Thrombectomy With Stent-Retrievers ― Cohort Study ―
- Source :
- Circulation Journal. 82:866-873
- Publication Year :
- 2018
- Publisher :
- Japanese Circulation Society, 2018.
-
Abstract
- Background The composition of intra-arterial clots might influence the efficacy of mechanical thrombectomy (MT) in ischemic stroke (IS) due to the acute occlusions within large cerebral arteries. The aims were to assess the factors associated with blood clot structure and the impact of thromboembolus structure on MT using stent-retrievers in patients with acute large artery IS in the anterior circulation.Methods and Results:In an observational cohort study, we studied the components of intra-arterial clots retrieved from large cerebral arteries in 80 patients with acute IS treated with MT with or without i.v. thrombolysis (IVT). Histology of the clots was carried out without knowledge of the clinical findings, including the treatment methods. The components of the clots, their age, origin and semi-quantitative graded changes in the architecture of the fibrin components (e.g., "thinning") were compared via neuro-interventional, clinical and laboratory data. The most prominent changes in the architecture of the fibrin components in the thromboemboli were associated with IVT (applied in 44 patients; OR, 3.50; 95% CI: 1.21-10.10, P=0.02) and platelet count (OR, 2.94; 95% CI: 1.06-8.12, P=0.04). Conclusions In patients with large artery IS treated with the MT using stent-retrievers, bridging therapy with IVT preceding MT and higher platelet count were associated with significant changes of the histological structure of blood clots.
- Subjects :
- Adult
Male
medicine.medical_specialty
Mechanical Thrombolysis
medicine.medical_treatment
Cerebral arteries
030204 cardiovascular system & hematology
Fibrin
Brain Ischemia
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Platelet
Stroke
Aged
Aged, 80 and over
biology
Platelet Count
business.industry
Thrombosis
Histology
General Medicine
Thrombolysis
Middle Aged
medicine.disease
Surgery
Mechanical thrombectomy
biology.protein
Female
Stents
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 13474820 and 13469843
- Volume :
- 82
- Database :
- OpenAIRE
- Journal :
- Circulation Journal
- Accession number :
- edsair.doi.dedup.....c7648b8d126bb1f0c70a14cf2b434f9c