[Exploration of thrombus histological composition and clinical effect in mechanical thrombectomy of acute ischemic stroke].

Objective: To explore histological composition of thrombus and clinical effect in mechanical thrombectomy of acute ischemic stroke. Methods: From March 2017 to August 2017 at the Institutes of Biology and Medical Sciences of Soochow University, hematoxylin and eosin (HE) staining was used to quantitatively analyze the composition of thrombus in 58 cases with acute ischemic stroke. The differences in components of thrombus with different TOAST classifications were compared, meanwhile, clinical data such as surgical process and prognosis were also analyzed. Results: (1) Baseline data: the age of arteriosclerosis was significantly lower than that of cardiogenic (P<0.05). There was statistically significant differences in onset to admission between the two types of stroke of other undetermined etiology (SUE) and Cardioembolism (CE) (P<0.05). (2) Histological composition of thrombus: there were no significant differences in fibrin and red blood cells (RBC) between the two types of SUE and CE thrombus (P>0.05). There were more RBC in LAA thrombus and more fibrin in CE thrombus (P<0.05). (3) Intraoperative data: the time of admission to recanalization of type LAA was longer than that of type CE (P<0.05). (4) Prognosis: there was no significant difference in the good prognosis between the two types of SUE and CE (P>0.05). It is the same between the types of LAA and CE (P>0.05). Conclusions: LAA thrombus contains more RBC, and cardiogenic thrombus contains more fibrin. Cryptogenic thrombus has the same composition with cardioembolism. The results may help to choose appropriate recanalization technique in different TOAST stroke and have guiding significance for the secondary prevention of SUE stroke.

Endovascular thrombolysis for severe cerebral sinus thrombosis.

SUMMARY: Cerebral venous and sinus thrombosis (CVST) is a rare but life-threatening disease accounting for less than 1% of all strokes and a poor outcome in around 10% of all patients. Early diagnosis is crucial because anticoagulation may reduce the risk of a fatal outcome and severe disability. However, the absence of specific features and the possibility of presentation without associated neurological signs can make its early recognition difficult. For these CVST patients with deteriorating symptoms, endovascular thrombolysis might give better outcome. We describe our five cases of CVST with clinical deteriorating symptoms treated with endovascular thrombolysis. Four patients made an excellent recovery, whereas one patient died despite maximal treatment including decompressive craniectomy.