Histological composition of retrieved emboli in acute ischemic stroke is independent of pre-thrombectomy alteplase use.

Aged Aged, 80 and over Brain Ischemia / diagnostic imaging Humans Ischemic Stroke / diagnosis Middle Aged Retrospective Studies Stroke / diagnostic imaging Thrombectomy / adverse effects Tissue Plasminogen Activator / adverse effects
Clot composition Stroke Thrombectomy r-TPA

Journal

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633

Informations de publication

Date de publication:
Apr 2022
Historique:
received: 18 12 2021
revised: 23 01 2022
accepted: 26 01 2022
pubmed: 21 2 2022
medline: 25 3 2022
entrez: 20 2 2022
Statut: ppublish

Résumé

Given recent evidence suggesting the clot composition may be associated with revascularization outcomes and stroke etiology, clot composition research has been a topic of growing interest. It is currently unclear what effect, if any, pre-thrombectomy thrombolysis has on clot composition. Understanding this association is important as it is a potential confounding variable in clot composition research. We retrospectively evaluated the composition of retrieved clots from ischemic stroke patients who did and did not receive pre-treatment tPA to study the effect of tPA on clot composition. Consecutive patients enrolled in the Stroke Thromboembolism Registry of Imaging and Pathology (STRIP) were included in this study. All patients underwent mechanical thrombectomy and retrieved clots were sent to a central core lab for processing. Histological analysis was performed using Martius Scarlett Blue (MSB) staining and area of the clot was also measured on the gross photos. Student's t test was used for continuous variables and chi-squared test for categorical variables. A total of 1430 patients were included in this study. Mean age was 68.4±13.5 years. Overall rate of TICI 2c/3 was 67%. A total of 517 patients received tPA (36%) and 913 patients did not (64%). Mean RBC density for the tPA group was 42.97±22.62% compared to 42.80±23.18% for the non-tPA group (P=0.89). Mean WBC density for the tPA group was 3.74±2.60% compared to 3.42±2.21% for the non-tPA group (P=0.012). Mean fibrin density for the tPA group was 26.52±15.81% compared to 26.53±15.34% for the non-tPA group (P=0.98). Mean platelet density for the tPA group was 26.22±18.60% compared to 26.55±19.47% for the non-tPA group (P=0.75). tPA group also had significantly smaller clot area compared to non-tPA group. Our study 1430 retrieved emboli and ischemic stroke patients shows no interaction between tPA administration and clot composition. These findings suggest that tPA does not result in any histological changes in clot composition.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
Given recent evidence suggesting the clot composition may be associated with revascularization outcomes and stroke etiology, clot composition research has been a topic of growing interest. It is currently unclear what effect, if any, pre-thrombectomy thrombolysis has on clot composition. Understanding this association is important as it is a potential confounding variable in clot composition research. We retrospectively evaluated the composition of retrieved clots from ischemic stroke patients who did and did not receive pre-treatment tPA to study the effect of tPA on clot composition.
MATERIALS AND METHODS METHODS
Consecutive patients enrolled in the Stroke Thromboembolism Registry of Imaging and Pathology (STRIP) were included in this study. All patients underwent mechanical thrombectomy and retrieved clots were sent to a central core lab for processing. Histological analysis was performed using Martius Scarlett Blue (MSB) staining and area of the clot was also measured on the gross photos. Student's t test was used for continuous variables and chi-squared test for categorical variables.
RESULTS RESULTS
A total of 1430 patients were included in this study. Mean age was 68.4±13.5 years. Overall rate of TICI 2c/3 was 67%. A total of 517 patients received tPA (36%) and 913 patients did not (64%). Mean RBC density for the tPA group was 42.97±22.62% compared to 42.80±23.18% for the non-tPA group (P=0.89). Mean WBC density for the tPA group was 3.74±2.60% compared to 3.42±2.21% for the non-tPA group (P=0.012). Mean fibrin density for the tPA group was 26.52±15.81% compared to 26.53±15.34% for the non-tPA group (P=0.98). Mean platelet density for the tPA group was 26.22±18.60% compared to 26.55±19.47% for the non-tPA group (P=0.75). tPA group also had significantly smaller clot area compared to non-tPA group.
CONCLUSIONS CONCLUSIONS
Our study 1430 retrieved emboli and ischemic stroke patients shows no interaction between tPA administration and clot composition. These findings suggest that tPA does not result in any histological changes in clot composition.

Identifiants

DOI: 10.1016/j.jstrokecerebrovasdis.2022.106376 PMID: 35183984
pubmed: 35183984
pii: S1052-3057(22)00073-8
doi: 10.1016/j.jstrokecerebrovasdis.2022.106376
pii:
doi:

Substances chimiques

Tissue Plasminogen Activator EC 3.4.21.68

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106376

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest None.

Auteurs

Waleed Brinjikji (W)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA. Electronic address: Brinjikji.Waleed@mayo.edu.

Mehdi Abbasi (M)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.

Oana Madalina Mereuta (OM)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.

Seán Fitzgerald (S)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.

Jorge Arturo Larco (JA)

Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.

Daying Dai (D)

Department of Radiology, Mayo Clinic, Rochester, MN, USA.

Ramanathan Kadirvel (R)

Department of Radiology, Mayo Clinic, Rochester, MN, USA.

Raul G Nogueira (RG)

Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.

Peter Kvamme (P)

Department of Radiology, University of Tennessee Medical Center, Knoxville, Tennessee, USA.

Kennith F Layton (KF)

Department of Radiology, Baylor University Medical Center, Dallas, Texas, USA.

Josser E Delgado (JE)

NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.

Ricardo A Hanel (RA)

Department of Neurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.

Vitor M Pereira (VM)

Departments of Medical Imaging and Surgery, Toronto Western Hospital, Toronto, Ontario, Canada.

Mohammed A Almekhlafi (MA)

Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Alberta, Canada.

Albert J Yoo (AJ)

Department of Neurointervention, Texas Stroke Institute, Plano, Texas, USA.

Babak S Jahromi (BS)

Departments of Radiology and Neurosurgery, Northwestern University, Chicago, IL, USA.

Matthew J Gounis (MJ)

Department of Radiology, New England Center for Stroke Research, University of Massachusetts, Worcester, Massachusetts, USA.

Biraj M Patel (BM)

Departments of Radiology and Neurosurgery, Carilion Clinic, Roanoke, VA, USA.

Luis E Savastano (LE)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.

Harry J Cloft (HJ)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.

Diogo C Haussen (DC)

Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.

Alhamza Al-Bayati (A)

Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.

Mahmoud Mohammaden (M)

Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.

Leonardo Pisani (L)

Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.

Gabriel Rodrigues (G)

Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, Georgia, USA.

Ike C Thacker (IC)

Department of Radiology, Baylor University Medical Center, Dallas, Texas, USA.

Yasha Kayan (Y)

NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.

Alexander Z Copelan (AZ)

NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.

Amin Aghaebrahim (A)

Department of Neurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.

Eric Sauvageau (E)

Department of Neurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.

Andrew M Demchuk (AM)

Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Alberta, Canada.

Parita Bhuva (P)

Department of Neurointervention, Texas Stroke Institute, Plano, Texas, USA.

Jazba Soomro (J)

Department of Neurointervention, Texas Stroke Institute, Plano, Texas, USA.

Pouya Nazari (P)

Departments of Radiology and Neurosurgery, Northwestern University, Chicago, IL, USA.

Donald Robert Cantrell (DR)

Departments of Radiology and Neurosurgery, Northwestern University, Chicago, IL, USA.

Ajit S Puri (AS)

Department of Radiology, New England Center for Stroke Research, University of Massachusetts, Worcester, Massachusetts, USA.

Karen M Doyle (KM)

Department of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.

John Entwistle (J)

Departments of Radiology and Neurosurgery, Carilion Clinic, Roanoke, VA, USA.

David F Kallmes (DF)

Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Histological composition of retrieved emboli...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Histological composition of retrieved emboli...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Encéphalopathie ischémique › Histological composition of retrieved emboli...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Histological composition of retrieved emboli...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Accident vasculaire cérébral ischémique › Histological composition of retrieved emboli...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Histological composition of retrieved emboli...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Histological composition of retrieved emboli...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Histological composition of retrieved emboli...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie cardiovasculaire › Procédures de chirurgie vasculaire › Thrombectomie › Histological composition of retrieved emboli...
questionsmedicales.fr › Facteurs biologiques › Facteurs de la coagulation sanguine › Activateur tissulaire du plasminogène › Histological composition of retrieved emboli...