1. Per pass analysis of thrombus composition retrieved by mechanical thrombectomy
- Author
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Amin Aghaebrahim, Kennith F. Layton, A Copelan, Vitor Mendes Pereira, Alhamza R Al-Bayati, Luis E. Savastano, Diogo C Haussen, Eric Sauvageau, Mahmoud H Mohammaden, J Delgado, Gabriel M Rodrigues, Mohammed A. Almekhlafi, David F. Kallmes, Ramanathan Kadirvel, Yasha Kayan, Yang Liu, Harry J. Cloft, Biraj M Patel, Seán Fitzgerald, Albert J Yoo, John J. Entwistle, Ike Thacker, Babak S. Jahromi, Ajit S. Puri, Mehdi Abbasi, Daying Dai, Peter Kvamme, Donald R. Cantrell, Pouya Nazari, Matthew J. Gounis, Andrew M. Demchuk, Karen M. Doyle, Jazba Soomro, Parita Bhuva, Ricardo A. Hanel, Oana Madalina Mereuta, Waleed Brinjikji, Raul G Nogueira, and Leonardo Pisani
- Subjects
Blood Platelets ,Fibrin ,medicine.medical_specialty ,business.industry ,Thrombosis ,Original Articles ,medicine.disease ,Stroke ,Mechanical thrombectomy ,Internal medicine ,medicine ,Cardiology ,Humans ,Thrombus ,business ,Thrombectomy ,Large vessel occlusion - Abstract
Background and aim Mechanical thrombectomy (MT) for large vessel occlusion often requires multiple passes to retrieve the entire thrombus load. In this multi-institutional study we sought to examine the composition of thrombus fragments retrieved with each pass during MT. Methods Patients who required multiple passes during thrombectomy were included. Histopathological evaluation of thrombus fragments retrieved from each pass was performed using Martius Scarlet Blue staining and the composition of each thrombus component including RBC, fibrin and platelet was determined using image analysis software. Results 154 patients underwent MT and 868 passes was performed which resulted in 263 thrombus fragments retrieval. The analysis of thrombus components per pass showed higher RBC, lower fibrin and platelet composition in the pass 1 and 2 when compared to pass 3 and passes 4 or more combined (P values 0.05). Similarly, when each composition of thrombus fragments retrieved in pass 3 and passes 4 or more combined were compared with each other, no significant difference was noted (P values >0.05). Conclusion Our findings confirm that thrombus fragments retrieved with each pass differed significantly in histological content. Fragments in the first passes were associated with lower fibrin and platelet composition compared to fragments retrieved in passes three and four or higher. Also, thrombus fragments retrieved after failed pass were associated with higher fibrin and platelet components.
- Published
- 2021