DOES PRIOR THROMBOLYSIS INFLUENCE HISTOLOGICAL COMPOSITION OF MECHANICALLY EXTRACTED THROMBI? FINDINGS FROM THE ANALYSIS OF THROMBI FROM 752 THROMBECTOMY PATIENTS IN THE RESTORE REGISTRY (ID 629)

Presentation Topic
AS05 THROMBOLYSIS – EXCLUDING CLINICAL TRIAL RESULTS
Presenter
Authors
Е-Poster Audio MP3

Abstract

Background And Aims

Intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatments for acute ischemic stroke (AIS). Recanalization may occur following IVT without further interventions or subsequent MT procedure may be needed. We compared size and histological composition of clots from 752 AIS patients undergoing bridging-therapy or MT alone for whom it was possible to collect thrombus material.

Methods

We took gross photos of each clot and we measured Extracted Clot Area (ECA) by drawing around each fragment using ImageJ software. We used Martius Scarlett Blue stain to characterize the main histological clot components (red blood cells (RBC), fibrin (FIB), platelets/other (PTL)) and Orbit Image Analysis for quantification. Additionally, we calculated the area of each main component by multiplying the component percent by ECA. For cases involving multiple passes we summed the values of ECAxComponent for all passes. Kruskal-Wallis test was used for statistical analysis.

Results

Thrombectomy-alone clots are bigger than bridging-therapy clots (36[20-71]mm2, versus 33[15-62]mm2, N=752,H1=5.123,P=0.024*). Analysis of percent and area of main histological clot components is shown in Table1:

Bridging-therapy(N=342)

MT alone(N=410)

Statistical analysis(N=752)

%RBC

41.10[25.10-55.78]%

41.12[22.83-59.29]%

H1=0.038,P=0.846

%FIB

29.60[20.03-39.97]%

28.25[18.66-41.93]%

H1=0.281,P=0.596

%PTL

20.61[11.11-33.71]%

18.93[11.13-32.88]%

H1=0.384,P=0.536

ECAxRBC(mm2)

12.19[3.76-29.37]

13.05[4.58-33.08]

H1=2.527,P=0.112

ECAxFIB(mm2)

8.91[4.35-18.12]

10.57[5.51-21.40]

H1=5.471,P=0.019*

ECAxPTL(mm2)

5.75[2.64-12.30]

7.61[3.44-14.45]

H1=6.580,P=0.010*

Results: median [IQ1-IQ3].

Conclusions

We did not find any difference in percent composition of main histological components for clots retrieved from the two patient populations, but bridging-therapy clots were smaller, containing less RBC and statistically significantly less fibrin and platelets.

Funding: Science Foundation Ireland (Grant Number 13/RC/2073_2) and Cerenovus.

Trial Registration Number

Not applicable

Hide

Е-Poster Audio MP3

Hide

Previous ePoster
FIBRINOGEN DEPLETION AND INTRACEREBRAL HEMORRHAGE AFTER THROMBOLYSIS FOR ISCHEMIC STROKE: A META-ANALYSIS (ID 386)

Next ePosters
PREDICTION OF HAEMORRHAGIC TRANSFORMATION BY BLOOD BRAIN BARRIER PERMEABILITY - IS TENECTEPLASE SAFER THAN ALTEPLASE? (ID 649)
BRIDGING-THERAPY WITH INTRAVENOUS THROMBOLYSIS DOES NOT COMPROMISE FUNCTIONAL AND PROCEDURAL OUTCOMES IN PATIENTS WITH ACUTE STROKE BY LARGE VESSEL OCCLUSION (ID 944)
UNDERSTANDING CURRENT PRACTICE PATTERNS REGARDING INTRAVENOUS THROMBOLYSIS IN PATIENTS WITH ACUTE STROKE ELIGIBLE FOR ENDOVASCULAR TREATMENT (ID 1802)
SAFETY AND EFFECTIVENESS OF IV THROMBOLYSIS IN RETINAL ARTERY OCCLUSION (ID 918)
B- MODE ULTRASOUND- GUIDED CATHETER- BASED Q-SWITCHED ND:YAG LASER AND EXTRACORPOREAL DUAL FREQUENCY ULTRASOUND COMBINATION THROMBOLYTIC THERAPY OF OCCLUDED ARTERY ACCOMPANIED BY THROMBOLYTIC AGENT ADMINISTRATION (ID 2041)
EARLY NEUROLOGICAL DETERIORATION IN LACUNAR STROKE: CLINICAL AND IMAGING PREDICTORS AND ASSOCIATION WITH LONG-TERM OUTCOME (ID 228)
DISCREPANCY BETWEEN POST-TREATMENT INFARCT VOLUME AND 90-DAY OUTCOME IN ISCHEMIC STROKE: A VALIDATION STUDY IN THE ESCAPE-NA1 RANDOMIZED CONTROLLED TRIAL (ID 776)
ADMISSION BLOOD PRESSURE IN RELATION TO OUTCOMES AFTER ENDOVASCULAR TREATMENT WITH OR WITHOUT PRIOR INTRAVENOUS THROMBOLYSIS: A MR CLEAN-NO IV SUBSTUDY (ID 833)
DO PATIENTS WHO DO NOT MEET CONSENSUS CRITERIA FOR MECHANICAL THROMBECTOMY STILL BENEFIT FROM IT? (ID 1184)
HOW LOW CAN YOU GO? OUTCOME OF ACUTE STROKE PATIENTS WITH ASPECTS 0-3 TREATED WITH MECHANICAL THROMBECTOMY (ID 1073)