Association between acute ischemic stroke etiology and macroscopic aspect of retrieved clots: is a clot's color a warning light for underlying pathologies?
infection
intervention
stroke
thrombectomy
tumor
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
06
03
2019
revised:
04
04
2019
accepted:
04
04
2019
pubmed:
6
5
2019
medline:
6
2
2020
entrez:
5
5
2019
Statut:
ppublish
Résumé
Few case reports have considered the chromatic aspect of retrieved clots and the possible association with their underlying etiology. The aim of our study was to analyze the frequency of the TOAST ischemic stroke typical (atrial fibrillation, dissection, atheroma) and atypical (infective endocarditis, cancer-related, valve-related thrombi) etiologies depending on the chromatic aspect of retrieved clots. A total of 255 anonymized and standardized clot photos of consecutive patients treated by mechanical thrombectomy for acute ischemic stroke were included. A double-blind evaluation was performed by two senior interventional neuroradiologists, who classified the visual aspects of the clots into two main patterns: red/black or white. Main patient characteristics, distribution of underlying stroke etiologies, and outcomes were compared between the two study groups. The inter-reader agreement for clot colors was excellent (k=0.78). Two hundred and thirty-three patients were classified as having red/black clots and 22 as having white clots. A statistically significant association (p=0.001) between atypical etiologies and white clots was observed. White clots were significantly associated with atypical etiologies in this cohort,in particular, with infectious endocarditis.
Sections du résumé
BACKGROUND
BACKGROUND
Few case reports have considered the chromatic aspect of retrieved clots and the possible association with their underlying etiology.
OBJECTIVE
OBJECTIVE
The aim of our study was to analyze the frequency of the TOAST ischemic stroke typical (atrial fibrillation, dissection, atheroma) and atypical (infective endocarditis, cancer-related, valve-related thrombi) etiologies depending on the chromatic aspect of retrieved clots.
METHODS
METHODS
A total of 255 anonymized and standardized clot photos of consecutive patients treated by mechanical thrombectomy for acute ischemic stroke were included. A double-blind evaluation was performed by two senior interventional neuroradiologists, who classified the visual aspects of the clots into two main patterns: red/black or white. Main patient characteristics, distribution of underlying stroke etiologies, and outcomes were compared between the two study groups.
RESULTS
RESULTS
The inter-reader agreement for clot colors was excellent (k=0.78). Two hundred and thirty-three patients were classified as having red/black clots and 22 as having white clots. A statistically significant association (p=0.001) between atypical etiologies and white clots was observed.
CONCLUSIONS
CONCLUSIONS
White clots were significantly associated with atypical etiologies in this cohort,in particular, with infectious endocarditis.
Identifiants
pubmed: 31053576
pii: neurintsurg-2019-014905
doi: 10.1136/neurintsurg-2019-014905
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1197-1200Informations de copyright
© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.