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Histological evaluation of acute ischemic stroke thrombi may indicate the occurrence of vessel wall injury during mechanical thrombectomy.
Mereuta, Oana Madalina; Abbasi, Mehdi; Fitzgerald, Seán; Dai, Daying; Kadirvel, Ram; Hanel, Ricardo A; Yoo, Albert J; Almekhlafi, Mohammed A; Layton, Kennith F; Delgado Almandoz, Josser E; Kvamme, Peter; Mendes Pereira, Vitor; Jahromi, Babak S; Nogueira, Raul G; Gounis, Matthew J; Patel, Biraj; Aghaebrahim, Amin; Sauvageau, Eric; Bhuva, Parita; Soomro, Jazba; Demchuk, Andrew M; Thacker, Ike C; Kayan, Yasha; Copelan, Alexander; Nazari, Pouya; Cantrell, Donald Robert; Haussen, Diogo C; Al-Bayati, Alhamza R; Mohammaden, Mahmoud; Pisani, Leonardo; Rodrigues, Gabriel Martins; Puri, Ajit S; Entwistle, John; Meves, Alexander; Arturo Larco, Jorge L; Savastano, Luis; Cloft, Harry J; Kallmes, David F; Doyle, Karen M; Brinjikji, Waleed.
Afiliación
  • Mereuta OM; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA oanamadalina.mereuta@nuigalway.ie.
  • Abbasi M; CÚRAM - SFI Research Centre for Medical Devices and Department of Physiology, National University of Ireland Galway, Galway, Ireland.
  • Fitzgerald S; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
  • Dai D; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
  • Kadirvel R; CÚRAM - SFI Research Centre for Medical Devices and Department of Physiology, National University of Ireland Galway, Galway, Ireland.
  • Hanel RA; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
  • Yoo AJ; Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
  • Almekhlafi MA; Department of Neurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.
  • Layton KF; Department of Neurointervention, Texas Stroke Institute, Dallas-Fort Worth, Texas, USA.
  • Delgado Almandoz JE; Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Kvamme P; Department of Radiology, Baylor University Medical Center, Dallas, Texas, USA.
  • Mendes Pereira V; Department of NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
  • Jahromi BS; Department of Radiology, University of Tennessee Medical Center, Knoxville, Tennessee, USA.
  • Nogueira RG; Departments of Medical Imaging and Surgery, Toronto Western Hospital, Toronto, Ontario, Canada.
  • Gounis MJ; Departments of Radiology and Neurosurgery, Northwestern University, Chicago, Illinois, USA.
  • Patel B; Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.
  • Aghaebrahim A; Emory University, Atlanta, Georgia, USA.
  • Sauvageau E; Department of Radiology, University of Massachusetts Medical School, New England Center for Stroke Research, Worcester, Massachusetts, USA.
  • Bhuva P; Departments of Radiology and Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA.
  • Soomro J; Department of Neurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.
  • Demchuk AM; Department of Neurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.
  • Thacker IC; Department of Neurointervention, Texas Stroke Institute, Dallas-Fort Worth, Texas, USA.
  • Kayan Y; Department of Neurointervention, Texas Stroke Institute, Dallas-Fort Worth, Texas, USA.
  • Copelan A; Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
  • Nazari P; Department of Radiology, Baylor University Medical Center, Dallas, Texas, USA.
  • Cantrell DR; Department of NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
  • Haussen DC; Department of NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
  • Al-Bayati AR; Departments of Radiology and Neurosurgery, Northwestern University, Chicago, Illinois, USA.
  • Mohammaden M; Departments of Radiology and Neurosurgery, Northwestern University, Chicago, Illinois, USA.
  • Pisani L; Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.
  • Rodrigues GM; Emory University, Atlanta, Georgia, USA.
  • Puri AS; Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.
  • Entwistle J; Emory University, Atlanta, Georgia, USA.
  • Meves A; Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.
  • Arturo Larco JL; Emory University, Atlanta, Georgia, USA.
  • Savastano L; Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.
  • Cloft HJ; Emory University, Atlanta, Georgia, USA.
  • Kallmes DF; Department of Neurology, Grady Memorial Hospital, Atlanta, Georgia, USA.
  • Doyle KM; Emory University, Atlanta, Georgia, USA.
  • Brinjikji W; Department of Radiology, University of Massachusetts Medical School, New England Center for Stroke Research, Worcester, Massachusetts, USA.
J Neurointerv Surg ; 14(4): 356-361, 2022 Apr.
Article en En | MEDLINE | ID: mdl-33975922
BACKGROUND: Several 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. OBJECTIVE: To investigate the occurrence of VWI during MT by histological and immunohistochemical evaluation of AIS clots. METHODS: As 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). RESULTS: MT 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. CONCLUSIONS: Histological 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Isquemia Encefálica / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: J Neurointerv Surg Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Isquemia Encefálica / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials Límite: Humans Idioma: En Revista: J Neurointerv Surg Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos
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