Abstract
We evaluated the composition of individual clots retrieved during intra-arterial thrombectomy in relation to recanalization success, stroke subtype, and the presence of clot signs on initial brain images. We analyzed clot and interventional data from 145 retrieval trials performed for 37 patients (69.5±14.0 years, 20 men, large artery atherosclerosis, n = 7; cardioembolism, n = 22; undetermined etiology, n = 8) who had undergone intra-arterial thrombectomy. Rates of clot retrieval and successful recanalization (Arterial Occlusive Lesion score of 2-3) for separate retrieval trials were evaluated. The area occupied by red blood cell (RBC), fibrin/platelets, and white blood cell (WBC) was measured from digitized images of hematoxylin-eosin stained clots. Compositional differences were compared according to recanalization success, stroke subtype, and the presence of hyperdense clot sign on initial computed tomography and/or blooming artifact on magnetic resonance image. Of the 145 total retrieval trials (3.4±2.4 times per patient), clot was retrieved in 93 trials (64%), while recanalization was successful in 73 (50%). Fibrin/platelets (63%) occupied the greatest area in retrieved clots, followed by RBCs (33%) and WBCs (4%). Clots r...Continue Reading
References
Jan 1, 1993·Stroke; a Journal of Cerebral Circulation·H P AdamsE E Marsh
Jul 19, 2003·Stroke; a Journal of Cerebral Circulation·Randall T HigashidaUNKNOWN Technology Assessment Committee of the Society of Interventional Radiology
Sep 26, 2006·Advances in Anatomic Pathology·Hadi Yaziji, Todd Barry
Sep 30, 2009·Neurology·P KhatriUNKNOWN IMS I and II Investigators
Dec 8, 2009·Thrombosis and Haemostasis·Kathryn C GershJohn W Weisel
Mar 10, 2010·Biomarker Insights·Leandro Luongo de MatosMaria Aparecida da Silva Pinhal
Oct 16, 2010·Stroke; a Journal of Cerebral Circulation·C RothW Reith
Mar 12, 2011·Stroke; a Journal of Cerebral Circulation·David S LiebeskindJeffrey L Saver
Dec 14, 2011·AJNR. American Journal of Neuroradiology·J PuigM Castellanos
Sep 1, 2012·Stroke; a Journal of Cerebral Circulation·Mikael MazighiPierre Amarenco
Nov 3, 2012·Journal of Neurointerventional Surgery·Marc RiboCarlos A Molina
Aug 8, 2013·Stroke; a Journal of Cerebral Circulation·Osama O ZaidatUNKNOWN STIR Thrombolysis in Cerebral Infarction (TICI) Task Force
Sep 21, 2013·Journal of Neurointerventional Surgery·Kaiz S AsifOsama Zaidat
Feb 11, 2014·Journal of Neurointerventional Surgery·Maxim MokinElad I Levy
Feb 14, 2014·PloS One·Joris M NiestenBirgitta K Velthuis
Feb 25, 2014·Journal of Neuroradiology. Journal De Neuroradiologie·Natasha SimonsBernard Yan
May 31, 2014·Stroke; a Journal of Cerebral Circulation·David S LiebeskindUNKNOWN SWIFT Investigators
Sep 28, 2014·Clinical Neuroradiology·T Boeckh-BehrensH Poppert
Dec 18, 2014·The New England Journal of Medicine·Olvert A BerkhemerUNKNOWN MR CLEAN Investigators
Feb 12, 2015·The New England Journal of Medicine·Mayank GoyalUNKNOWN ESCAPE Trial Investigators
Feb 19, 2015·Journal of Stroke·Hye Seon JeongJei Kim
Jul 15, 2015·AJNR. American Journal of Neuroradiology·S K KimM S Park
Apr 9, 2016·International Journal of Stroke : Official Journal of the International Stroke Society·Seong Hwan AhnJin Ho Kim
May 21, 2016·Stroke; a Journal of Cerebral Circulation·Tobias Boeckh-BehrensHolger Poppert
Oct 27, 2016·Stroke; a Journal of Cerebral Circulation·Tetsuya HashimotoKazunori Toyoda
Nov 20, 2016·The Journal of Emergency Medicine·William J MeurerSamuel H F Lam
Jun 9, 2017·Journal of Stroke·Albert J Yoo, Tommy Andersson
Citations
Apr 4, 2019·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Zenith KhashimDavid F Kallmes
Jun 11, 2019·Internal Medicine·Genki UsuiTeppei Morikawa
Feb 7, 2020·Journal of Stroke·Ji Hoe HeoIl Kwon
Jan 22, 2020·Neurology·Vincent L'AllinecUNKNOWN Endovascular Treatment in Ischemic Stroke Investigators
Oct 12, 2019·Clinical Neuroradiology·Ana Siri LuthmanKarl-Olof Lövblad
Apr 21, 2020·Platelets·Senna Staessens, Simon F De Meyer
Apr 6, 2019·Frontiers in Neurology·Oh Young BangPyoung Jeon
Jun 27, 2019·Journal of Neurointerventional Surgery·John Charles BensonWaleed Brinjikji
Sep 3, 2019·Frontiers in Neurology·Gengfan YeDaming Wang
Oct 11, 2020·International Journal of Molecular Sciences·Fabian EssigMichael K Schuhmann
Nov 27, 2020·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Tomohiko OzakiVitor Mendes Pereira
Jan 14, 2021·International Journal of Stroke : Official Journal of the International Stroke Society·Jean DarcourtChristophe Cognard
Feb 11, 2021·Stroke; a Journal of Cerebral Circulation·Precious Jolugbo, Robert A S Ariëns
Feb 13, 2021·Journal of Neurointerventional Surgery·Yong-Hong DingRamanathan Kadirvel
Nov 28, 2020·AJNR. American Journal of Neuroradiology·T R PatelV M Tutino
Oct 30, 2020·Journal of Neurointerventional Surgery·Yong-Hong DingWaleed Brinjikji
Dec 10, 2020·Neurointervention·Yonghong DingWaleed Brinjikji
Apr 21, 2021·Scientific Reports·Florian C RoesslerGeorg Royl
Jul 16, 2021·Arteriosclerosis, Thrombosis, and Vascular Biology·Ghadir AlkarithiRobert A S Ariëns
Jul 25, 2021·AJNR. American Journal of Neuroradiology·J C BensonW Brinjikji
Jul 6, 2021·Thrombosis and Haemostasis·Gerrit M GrosseRamona Schuppner
Aug 17, 2021·Cellular and Molecular Life Sciences : CMLS·Rentang BiBo Hu
Sep 15, 2021·Stroke; a Journal of Cerebral Circulation·Senna StaessensSimon F De Meyer
Sep 21, 2021·Stroke; a Journal of Cerebral Circulation·Marie CoutureUNKNOWN ETIS Registry Investigators*
Oct 12, 2021·Neurosurgery·Ankur BhambriAditya S Pandey
Nov 16, 2021·Thrombosis and Haemostasis·Martin MalyJan E Dyr
Dec 19, 2021·Cardiovascular and Interventional Radiology·Schekeb AludinJens Trentmann
Jun 5, 2021·Journal of Neurosurgery·Yang LiuLuis E Savastano