High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy.
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 (6...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC5962078?pdf=render |
| _version_ | 1818022870583869440 |
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| author | Jong Wook Shin Hye Seon Jeong Hyon-Jo Kwon Kyu Sang Song Jei Kim |
| author_facet | Jong Wook Shin Hye Seon Jeong Hyon-Jo Kwon Kyu Sang Song Jei Kim |
| author_sort | Jong Wook Shin |
| collection | DOAJ |
| description | 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 retrieved from successful recanalization exhibited higher RBC composition (37%) than those retrieved from non-recanalization trials (20%, p = 0.001). RBC composition was higher in cardioembolic stroke (38%) rather than large artery atherosclerosis (23%) and undetermined etiology (26%, p = 0.01). Clots exhibiting clot signs (40%) had higher RBC composition than those without clot signs (19%, p = 0.001). RBC-rich clots were associated with successful recanalization of intra-arterial thrombectomy, cardioembolic stroke, and the presence of clot-signs on initial brain images. |
| first_indexed | 2024-12-10T03:35:18Z |
| format | Article |
| id | doaj.art-ba66009520e64bff803647ab16a9d8ea |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T03:35:18Z |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ba66009520e64bff803647ab16a9d8ea2022-12-22T02:03:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01135e019749210.1371/journal.pone.0197492High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy.Jong Wook ShinHye Seon JeongHyon-Jo KwonKyu Sang SongJei KimWe 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 retrieved from successful recanalization exhibited higher RBC composition (37%) than those retrieved from non-recanalization trials (20%, p = 0.001). RBC composition was higher in cardioembolic stroke (38%) rather than large artery atherosclerosis (23%) and undetermined etiology (26%, p = 0.01). Clots exhibiting clot signs (40%) had higher RBC composition than those without clot signs (19%, p = 0.001). RBC-rich clots were associated with successful recanalization of intra-arterial thrombectomy, cardioembolic stroke, and the presence of clot-signs on initial brain images.http://europepmc.org/articles/PMC5962078?pdf=render |
| spellingShingle | Jong Wook Shin Hye Seon Jeong Hyon-Jo Kwon Kyu Sang Song Jei Kim High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy. PLoS ONE |
| title | High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy. |
| title_full | High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy. |
| title_fullStr | High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy. |
| title_full_unstemmed | High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy. |
| title_short | High red blood cell composition in clots is associated with successful recanalization during intra-arterial thrombectomy. |
| title_sort | high red blood cell composition in clots is associated with successful recanalization during intra arterial thrombectomy |
| url | http://europepmc.org/articles/PMC5962078?pdf=render |
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