Histological evaluation of acute ischemic stroke thrombi may indicate the occurrence of vessel wall injury during mechanical thrombectomy
| Autor: | Josser E Delgado Almandoz, Mahmoud H Mohammaden, Eric Sauvageau, Amin Aghaebrahim, Albert J Yoo, Mehdi Abbasi, Alhamza R Al-Bayati, Pouya Nazari, Raul G Nogueira, Oana Madalina Mereuta, Kennith F. Layton, Jazba Soomro, David F. Kallmes, John J. Entwistle, Harry J. Cloft, Jorge L Arturo Larco, Biraj M Patel, Parita Bhuva, Diogo C Haussen, Seán Fitzgerald, Daying Dai, Vitor Mendes Pereira, Ike Thacker, Leonardo Pisani, Babak S. Jahromi, Mohammed A. Almekhlafi, Donald R. Cantrell, Peter Kvamme, Waleed Brinjikji, Yasha Kayan, A Copelan, Luis E. Savastano, Alexander Meves, Karen M. Doyle, Gabriel M Rodrigues, R Kadirvel, Ricardo A. Hanel, Ajit S. Puri, Andrew M. Demchuk, Matthew J. Gounis |
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| Rok vydání: | 2021 |
| Předmět: |
Pathology
medicine.medical_specialty medicine.medical_treatment Cerebral arteries CD34 030204 cardiovascular system & hematology Revascularization Brain Ischemia mechanical thrombectomy 03 medical and health sciences 0302 clinical medicine medicine Humans Platelet Thrombus Stroke Ischemic Stroke Thrombectomy business.industry Endothelial Cells Thrombosis General Medicine Thrombolysis medicine.disease Treatment Outcome acute ischemic stroke thrombi Immunohistochemistry Surgery Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | Journal of NeuroInterventional Surgery. 14:356-361 |
| ISSN: | 1759-8486 1759-8478 |
| Popis: | BackgroundSeveral animal studies have demonstrated that mechanical thrombectomy (MT) for acute ischemic stroke (AIS) may cause vessel wall injury (VWI). However, the histological changes in human cerebral arteries following MT are difficult to determine.ObjectiveTo investigate the occurrence of VWI during MT by histological and immunohistochemical evaluation of AIS clots.MethodsAs part of the multicenter STRIP registry, 277 clots from 237 patients were analyzed using Martius Scarlett Blue stain and immunohistochemistry for CD34 (endothelial cells) and smooth muscle actin (smooth muscle cells).ResultsMT devices used were aspiration catheters (100 cases), stentriever (101 cases), and both (36 cases). VWI was found in 33/277 clots (12%). There was no significant correlation between VWI and MT device. The degree of damage varied from grade I (mild intimal damage, 24 clots), to grade II (relevant intimal and subintimal damage, 3 clots), and III (severe injury, 6 clots). VWI clots contained significantly more erythrocytes (p=0.006*) and less platelets/other (p=0.005*) than non-VWI clots suggesting soft thrombus material.Thrombolysis correlated with a lower rate of VWI (p=0.04*). VWI cases showed a significantly higher number of passes (2 [1–4] vs 1 [1–3], p=0.028*) and poorer recanalization outcome (p=0.01*) than cases without VWI.ConclusionsHistological markers of VWI were present in 12% of AIS thrombi, suggesting that VWI might be related to MT. VWI was associated with soft thrombus consistency, higher number of passes and poorer revascularization outcome. There was no significant correlation between VWI and MT device. |
| Databáze: | OpenAIRE |
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