Whole-Brain Susceptibility-Weighted Thrombus Imaging in Stroke: Fragmented Thrombi Predict Worse Outcome.

AJNR. American Journal of Neuroradiology
Pascal P GratzMarwan El-Koussy

Abstract

The prevalence and clinical importance of primarily fragmented thrombi in patients with acute ischemic stroke remains elusive. Whole-brain SWI was used to detect multiple thrombus fragments, and their clinical significance was analyzed. Pretreatment SWI was analyzed for the presence of a single intracranial thrombus or multiple intracranial thrombi. Associations with baseline clinical characteristics, complications, and clinical outcome were studied. Single intracranial thrombi were detected in 300 (92.6%), and multiple thrombi, in 24 of 324 patients (7.4%). In 23 patients with multiple thrombi, all thrombus fragments were located in the vascular territory distal to the primary occluding thrombus; in 1 patient, thrombi were found both in the anterior and posterior circulation. Only a minority of thrombus fragments were detected on TOF-MRA, first-pass gadolinium-enhanced MRA, or DSA. Patients with multiple intracranial thrombi presented with more severe symptoms (median NIHSS scores, 15 versus 11; P = .014) and larger ischemic areas (median DWI ASPECTS, 5 versus 7; P = .006); good collaterals, rated on DSA, were fewer than those in patients with a single thrombus (21.1% versus 44.2%, P = .051). The presence of multiple thrombi w...Continue Reading

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Citations

Nov 26, 2015·Expert Review of Medical Devices·Pasquale Mordasini, Jan Gralla
Feb 6, 2016·Journal of Stroke·Min-Gyu ParkKyung-Pil Park
Sep 1, 2015·Neuroradiology·Pascal P Klinger-GratzMarwan El-Koussy
Nov 9, 2016·Insights Into Imaging·Sébastien VerclytteJean-François Budzik
Feb 28, 2016·Journal of Neurointerventional Surgery·Ju-Yu ChuehMatthew J Gounis
Feb 19, 2016·Journal of Neurointerventional Surgery·Justus F KleineJohannes Kaesmacher
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Sep 5, 2018·Journal of Neurointerventional Surgery·Jildaz CaroffJu-Yu Chueh
Jun 9, 2017·Journal of Stroke·Albert J Yoo, Tommy Andersson
Feb 4, 2019·Journal of Neurointerventional Surgery·Thanh N NguyenOsama O Zaidat
Oct 1, 2020·Stroke; a Journal of Cerebral Circulation·Johannes KaesmacherUrs Fischer
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Aug 20, 2021·Stroke; a Journal of Cerebral Circulation·Daniel A PaydarfarJoshua Chang
Apr 2, 2020·Interventional Neurology·Asim RizviDavid F Kallmes

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