Περίληψη:
Introduction: We assessed the correlation between thrombus size before
and after mechanical thrombectomy, measured as length by Computed
Tomography Angiography/Non-Contrast Computed Tomography (CTA/NCCT) and
Extracted Clot Area, ECA, respectively. We also assessed the influence
of thrombus size on the number of passes required for clot removal and
final recanalization outcome.
Materials and methods: Acute ischaemic stroke (AIS) thrombi retrieved by
mechanical thrombectomy from 500 patients and data of clot length by
CTA/NCCT were collected from three hospitals in Europe. ECA was obtained
by measuring the area of the extracted clot. Non-parametric tests were
used for data analysis.
Results: A strong positive correlation was found between clot length on
CTA/NCCT and ECA (rho = 0.619,N = 500, P < 0.0001*). Vessel size
influences clot length on CTA/NCCT (H2 = 98.6, P < 0.0001*) and ECA
(H2 = 105.6,P < 0.0001*), but the significant correlation between
CTA/NCCT length and ECA was evident in all vessels. Poorer
revascularisation outcome was associated with more passes (H5 = 73.1, P
< 0.0001*). More passes were required to remove longer clots
(CTA/NCCT; H4 = 31.4, P < 0.0001*; ECA; H4 = 50.2, P < 0.0001*).
There was no significant main association between recanalization outcome
and length on CTA/NCCT or ECA, but medium sized clots (ECA 20-40 mm(2))
were associated with least passes and highest revascularisation outcome
(N = 500, X-2 = 16.2, P < 0.0001*).
Conclusion: Clot length on CTA/NCCT strongly correlates with ECA.
Occlusion location influences clot size. More passes are associated with
poorer revascularisation outcome and bigger clots. The relationship
between size and revascularisation outcome is more complex. Clots of
medium ECA take less passes to remove and are associated with better
recanalization outcome than both smaller and larger clots.
Συγγραφείς:
Rossi, Rosanna
Fitzgerald, Sean
Gil, Sara M.
Mereuta, Oana
M.
Douglas, Andrew
Pandit, Abhay
Brennan, Paul
Power,
Sarah
Alderson, Jack
O'Hare, Alan
Gilvarry, Michael and
McCarthy, Ray
Psychogios, Klearchos
Magoufis, Georgios and
Tsivgoulis, Georgios
Szikora, Istvan
Jood, Katarina
Redfors,
Petra
Nordanstig, Annika
Ceder, Erik
Tatlisumak, Turgut and
Rentzos, Alexandros
Thornton, John
Doyle, Karen M.
