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Does prior administ...
Does prior administration of rtPA influence acute ischemic stroke clot composition? Findings from the analysis of clots retrieved with mechanical thrombectomy from the RESTORE registry.
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2021-08-20
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Springer Science and Business Media LLC,2022
Numbers
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LIBRIS-ID:oai:gup.ub.gu.se/306860
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https://gup.ub.gu.se/publication/306860URI
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https://doi.org/10.1007/s00415-021-10758-5DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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There is still much debate whether bridging-therapy [intravenous thrombolysis (IVT) prior to mechanical thrombectomy (MT)] might be beneficial compared to MT alone. We investigated the effect of IVT on size and histological composition of the clots retrieved from patients undergoing bridging-therapy or MT alone.We collected mechanically extracted thrombi from 1000 acute ischemic stroke (AIS) patients included in RESTORE registry. Patients were grouped according to the administration (or not) of IVT before thrombectomy. Gross photos of each clot were taken and Extracted Clot Area (ECA) was measured using ImageJ software. Martius Scarlett Blue stain was used to characterize the main histological clot components [red blood cells (RBCs), fibrin (FIB), platelets/other (PTL)] and Orbit Image Analysis was used for quantification. Additionally, we calculated the area of each main component by multiplying the component percent by ECA. Chi-squared and Kruskal-Wallis tests were used for statistical analysis.451 patients (45%) were treated with bridging-therapy while 549 (55%) underwent MT alone. When considering only percent histological composition, we did not find any difference in RBC% (P=0.895), FIB% (P=0.458) and PTL% (P=0.905). However, bridging-therapy clots were significantly smaller than MT-alone clots [32.7 (14.8-64.9) versus 36.8 (20.1-79.8) mm2, N=1000, H1=7.679, P=0.006*]. A further analysis expressing components per clot area showed that clots retrieved from bridging-therapy cases contained less RBCs [13.25 (4.29-32.06) versus 14.97 (4.93-39.80) mm2, H1=3.637, P=0.056] and significantly less fibrin [9.10 (4.62-17.98) versus 10.54 (5.57-22.48) mm2, H1=7.920, P=0.005*] and platelets/other [5.04 (2.26-11.32) versus 6.54 (2.94-13.79) mm2, H1=9.380, P=0.002*] than MT-alone clots.Our results suggest that previous IVT administration significantly reduces thrombus size, proportionally releasing all the main histological components.
Subject headings and genre
Added entries (persons, corporate bodies, meetings, titles ...)
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Molina, Sara
(author)
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Mereuta, Oana Madalina
(author)
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Douglas, Andrew
(author)
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Fitzgerald, Seán
(author)
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Tierney, Ciara
(author)
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Pandit, Abhay
(author)
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Brennan, Paul
(author)
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Power, Sarah
(author)
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O'Hare, Alan
(author)
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Gilvarry, Michael
(author)
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McCarthy, Ray
(author)
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Magoufis, Georgios
(author)
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Tsivgoulis, Georgios
(author)
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Nagy, András
(author)
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Vadász, Ágnes
(author)
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Jood, Katarina,1966Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xjooka
(author)
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Redfors, PetraGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xredpe
(author)
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Nordanstig, Annika,1974Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xnoraz
(author)
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Ceder, ErikGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology
(author)
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Dunker, DennisGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology
(author)
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Carlqvist, JeanetteGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xcajea
(author)
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Psychogios, Klearchos
(author)
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Szikora, István
(author)
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Tatlisumak, TurgutGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xtatlt
(author)
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Rentzos, Alexandros,1979Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xrenta
(author)
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Thornton, John
(author)
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Doyle, Karen M
(author)
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Göteborgs universitetInstitutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap
(creator_code:org_t)
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In:Journal of neurology: Springer Science and Business Media LLC269:4, s. 1913-19201432-14590340-5354
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Rossi, Rosanna
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Molina, Sara
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Mereuta, Oana Ma ...
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Douglas, Andrew
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Fitzgerald, Seán
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Tierney, Ciara
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Pandit, Abhay
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Brennan, Paul
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Power, Sarah
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O'Hare, Alan
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McCarthy, Ray
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Magoufis, Georgi ...
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Tsivgoulis, Geor ...
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Nagy, András
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Vadász, Ágnes
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Jood, Katarina, ...
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Redfors, Petra
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Nordanstig, Anni ...
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Ceder, Erik
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Dunker, Dennis
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Psychogios, Klea ...
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Szikora, István
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