Περίληψη:
Background Initial studies investigating correlations between stroke
etiology and clot composition are conflicting and do not account for
clot size as determined by area. Radiological studies have shown that
cardioembolic strokes are associated with shorter clot lengths and lower
clot burden than non-cardioembolic clots. Objective To report the
relationship between stroke etiology, extracted clot area, and
histological composition at each procedural pass. Methods As part of the
multi-institutional RESTORE Registry, the Martius Scarlett Blue stained
histological composition and extracted clot area of 612 per-pass clots
retrieved from 441 patients during mechanical thrombectomy procedures
were quantified. Correlations with clinical and procedural details were
investigated. Results Clot composition varied significantly with
procedural passes; clots retrieved in earlier passes had higher red
blood cell content (H4=11.644, p=0.020) and larger extracted clot area
(H4=10.730, p=0.030). Later passes were associated with significantly
higher fibrin (H4=12.935, p=0.012) and platelets/other (H4=15.977,
p=0.003) content and smaller extracted clot area. Large artery
atherosclerotic (LAA) clots were significantly larger in the extracted
clot area and more red blood cell-rich than other etiologies in passes
1-3. Cardioembolic and cryptogenic clots had similar histological
composition and extracted clot area across all procedural passes.
Conclusion LAA clots are larger and associated with a large red blood
cell-rich extracted clot area, suggesting soft thrombus material.
Cardioembolic clots are smaller in the extracted clot area, consistent
in composition and area across passes, and have higher fibrin and
platelets/other content than LAA clots, making them stiffer clots. The
per-pass histological composition and extracted clot area of cryptogenic
clots are similar to those of cardioembolic clots, suggesting similar
formation mechanisms.
Συγγραφείς:
Fitzgerald, Sean
Rossi, Rosanna
Mereuta, Oana Madalina and
Jabrah, Duaa
Okolo, Adaobi
Douglas, Andrew
Molina Gil, Sara
and Pandit, Abhay
McCarthy, Ray
Gilvarry, Michael
Dunker,
Dennis
Nordanstig, Annika
Ceder, Erik
Redfors, Petra and
Jood, Katarina
Dehlfors, Niclas
Magoufis, Georgios and
Tsivgoulis, Georgios
Brinjikji, Waleed
Kallmes, David F. and
O'Hare, Alan
Power, Sarah
Brennan, Paul
Alderson, Jack and
Nagy, Andras
Vadasz, Agnes
Psychogios, Klearchos
Szikora,
Istvan
Tatlisumak, Turgut
Rentzos, Alexandros
Thornton, John
and Doyle, Karen M.
