S-EPMC7755299 - Large Artery Atherosclerotic Clots are Larger than Clots of other Stroke Etiologies and have Poorer Recanalization rates. - OmicsDI

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Dataset Information

Large Artery Atherosclerotic Clots are Larger than Clots of other Stroke Etiologies and have Poorer Recanalization rates.

ABSTRACT:

Objectives

There is a paucity of knowledge in the literature relating to the extent of clot burden and stroke etiology. In this study, we measured the Extracted Clot Area (ECA) retrieved during endovascular treatment (EVT) and investigated relationships with suspected etiology, administration of intravenous thrombolysis and recanalization.

Materials and methods

As part of the multi-institutional RESTORE registry, the ECA retrieved during mechanical thrombectomy was quantified using ImageJ. The effect of stroke etiology (Large-artery atherosclerosis (LAA), Cardioembolism, Cryptogenic and other) and recombinant tissue plasminogen activator (rtPA) on ECA and recanalization outcome (mTICI) was assessed. Successful recanalization was described as mTICI 2c-3.

Results

A total of 550 patients who underwent EVT with any clot retrieved were included in the study. The ECA was significantly larger in the LAA group compared to all other etiologies. The average ECA size of each etiology was; LAA=109 mm², Cardioembolic=52 mm², Cryptogenic=47 mm² and Other=52 mm² (p=0.014*). LAA patients also had a significantly poorer rate of successful recanalization (mTICI 2c-3) compared to all other etiologies (p=0.003*). The administration of tPA was associated with a smaller ECA in both LAA (p=0.007*) and cardioembolic (p=0.035*) groups.

Conclusion

The ECA of LAA clots was double the size of all other etiologies and this is associated with a lower rate of successful recanalization in LAA stroke subtype. rtPA administration prior to thrombectomy was associated with reduced ECA in LAA and CE clots.

SUBMITTER: Fitzgerald S

PROVIDER: S-EPMC7755299 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Large Artery Atherosclerotic Clots are Larger than Clots of other Stroke Etiologies and have Poorer Recanalization rates.

Fitzgerald Seán S Rossi Rosanna R Mereuta Oana Madalina OM Molina Sara S Okolo Adaobi A Douglas Andrew A Jabrah Duaa D Pandit Abhay A McCarthy Ray R Gilvarry Michael M Ceder Erik E Dehlfors Niclas N Dunker Dennis D Nordanstig Annika A Redfors Petra P Jood Katarina K Magoufis Georgios G Psychogios Klearchos K Tsivgoulis Georgios G Alderson Jack J O'Hare Alan A Power Sarah S Brennan Paul P Nagy András A Vadász Ágnes Á Brinjikji Waleed W Kallmes David D Szikora Istvan I Tatlisumak Turgut T Rentzos Alexandros A Thornton John J Doyle Karen M KM

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 20201124 1

<h4>Objectives</h4>There is a paucity of knowledge in the literature relating to the extent of clot burden and stroke etiology. In this study, we measured the Extracted Clot Area (ECA) retrieved during endovascular treatment (EVT) and investigated relationships with suspected etiology, administration of intravenous thrombolysis and recanalization.<h4>Materials and methods</h4>As part of the multi-institutional RESTORE registry, the ECA retrieved during mechanical thrombectomy was quantified usin ...[more]

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