Nyk Aberson (Netherlands)
Amsterdam University Medical Centers, location AMC Radiology and Nuclear medicineAuthor Of 1 Presentation
ASSOCIATION OF THROMBUS DENSITY IN PATIENTS WITH M1 OCCLUSIONS WITH OUTCOME
Abstract
Group Name
MR CLEAN Registry investigators
Background And Aims
The association of thrombus density with reperfusion and functional outcome remains conflicted in acute ischemic stroke. We evaluated if hyperdense thrombi were associated with reperfusion and functional outcome after endovascular treatment (EVT).
Methods
Thrombus imaging characteristics were measured in patients with M1 occlusions included in the MR CLEAN Registry. Thrombus density was measured on thin-slice (<2.5 mm) non-contrast computed tomography. Based on median density across the dataset, hyperdense thrombi were defined as thrombi >50 Hounsfield Units (HU). Regression models were used to investigate the association between hyperdense thrombi, successful reperfusion (expanded Treatment In Cerebral Ischemia (eTICI) score 2B-3), and favorable and excellent functional outcome (modified Rankin Scale (mRS) of 0-2 and 0-1, respectively) at 90 days. We adjusted for age, gender, baseline National Institutes of Health Stroke Scale, prestroke mRS, clot burden score, intravenous alteplase treatment (IVT) and carotid tandem lesions. Subgroup analyses were performed in patients treated with or without IVT prior to EVT.
Results
In 434 analyzed patients, hyperdense thrombi were not associated with successful reperfusion (aOR 0.99 [95%CI 0.65-1.51]) or favorable functional outcome (aOR 1.28 [95%CI 0.81-2.01]). Hyperdense thrombi were inversely associated with excellent functional outcome (aOR 0.52 [95%CI 0.32-0.85]). This association was stronger in patients treated with IVT prior to EVT (aOR 0.47 [95%CI 0.26-0.85]) than in patients directly treated with EVT (aOR 0.85 [95%CI 0.29-2.52]) (Figure 1).
Conclusions
Hyperdense thrombi were not significantly associated with reperfusion or favorable functional outcome. However, patients with hyperdense thrombi less often achieved excellent functional outcome after EVT.
Trial Registration Number
N/A
Presenter of 1 Presentation
ASSOCIATION OF THROMBUS DENSITY IN PATIENTS WITH M1 OCCLUSIONS WITH OUTCOME
Abstract
Group Name
MR CLEAN Registry investigators
Background And Aims
The association of thrombus density with reperfusion and functional outcome remains conflicted in acute ischemic stroke. We evaluated if hyperdense thrombi were associated with reperfusion and functional outcome after endovascular treatment (EVT).
Methods
Thrombus imaging characteristics were measured in patients with M1 occlusions included in the MR CLEAN Registry. Thrombus density was measured on thin-slice (<2.5 mm) non-contrast computed tomography. Based on median density across the dataset, hyperdense thrombi were defined as thrombi >50 Hounsfield Units (HU). Regression models were used to investigate the association between hyperdense thrombi, successful reperfusion (expanded Treatment In Cerebral Ischemia (eTICI) score 2B-3), and favorable and excellent functional outcome (modified Rankin Scale (mRS) of 0-2 and 0-1, respectively) at 90 days. We adjusted for age, gender, baseline National Institutes of Health Stroke Scale, prestroke mRS, clot burden score, intravenous alteplase treatment (IVT) and carotid tandem lesions. Subgroup analyses were performed in patients treated with or without IVT prior to EVT.
Results
In 434 analyzed patients, hyperdense thrombi were not associated with successful reperfusion (aOR 0.99 [95%CI 0.65-1.51]) or favorable functional outcome (aOR 1.28 [95%CI 0.81-2.01]). Hyperdense thrombi were inversely associated with excellent functional outcome (aOR 0.52 [95%CI 0.32-0.85]). This association was stronger in patients treated with IVT prior to EVT (aOR 0.47 [95%CI 0.26-0.85]) than in patients directly treated with EVT (aOR 0.85 [95%CI 0.29-2.52]) (Figure 1).
Conclusions
Hyperdense thrombi were not significantly associated with reperfusion or favorable functional outcome. However, patients with hyperdense thrombi less often achieved excellent functional outcome after EVT.
Trial Registration Number
N/A