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Please use this identifier to cite or link to this item: http://hdl.handle.net/10564/4084

Title: Age and composition of the thrombus retrieved by mechanical thrombectomy from patients with acute ischemic stroke are associated with revascularization and clinical outcomes.
Other Titles: 急性期虚血性脳卒中患者から機械的血栓回収術で得られた血栓の年齢と組成は血栓回収術転帰および臨床転帰と関連していた
Authors: Shimizu, Hisao
Hatakeyama, Kinta
Saito, Kozue
Shobatake, Ryogo
Takahashi, Nobuyuki
Deguchi, Jun
Tokunaga, Hidemori
Shimada, Keiji
Nakagawa, Ichiro
Myochin, Kaoru
Sakai, Kazuya
Kubo, Masayuki
Yamashita, Atsushi
Obayashi, Chiho
Sugie, Kazuma
Matsumoto, Masanori
Keywords: Thrombus age
Mechanical thrombectomy
Acute ischemic stroke
Issue Date: Nov-2022
Publisher: Elsevier
Citation: Thrombosis research Vol.219 p.60-69 (2022 Nov)
Abstract: Introduction: Understanding the composition of stroke thrombi retrieved by mechanical thrombectomy is essential to clarify the pathogenesis of stroke. However, it is difficult to evaluate thrombus composition precisely and objectively. Immunohistochemical staining was used to evaluate thrombus composition and age. Materials and methods: Consecutive thrombi (n = 108) retrieved from patients who underwent mechanical thrombectomy for acute large-vessel ischemic stroke were retrospectively analyzed. Lytic features of granulocytes and CD163 were estimated as indicators of the age of the cardioembolic (CE) thrombus. Results: The stroke subtypes were as follows: CE, 74 cases; large artery atherosclerosis, 11; undetermined etiology, 12; and other determined etiology, 11. There were no statistical differences in thrombi composition according to stroke subtypes. The fibrin area was positively correlated with the red blood cell (RBC) and platelet areas. The following analysis was performed using CE only. Regarding age, the thrombus was judged as fresh in 30.0 % and older in 70.0 % based on the lytic features. The RBC areas of older thrombi were smaller than those of fresh thrombi. The puncture-to-reperfusion time of older thrombi was longer than that of fresh thrombi. Platelet-rich thrombi were associated with a greater number of maneuvers, a smaller prevalence of TICI 3, and unfavorable functional outcomes compared to platelet-poor thrombi. The number of CD163 positive cells in thrombi with anticoagulants was higher than in those without anticoagulants. Conclusion: Thrombus composition correlated with revascularization and clinical outcomes. The composition of an acute ischemic thrombus may reflect the pathophysiology of stroke and influence treatment efficacy.
Description: 博士(医学)・甲第855号・令和4年12月22日
Copyright © 2022 Elsevier Ltd. All rights reserved.
URI: http://hdl.handle.net/10564/4084
ISSN: 00493848
Academic Degrees and number: 24601A855
Degree-granting date: 2022-12-22
Degree name: 博士(医学)
Degree-granting institutions: 奈良県立医科大学
Appears in Collections:2022年度

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