PMID- 29058984
OWN - NLM
STAT- MEDLINE
DCOM- 20180717
LR  - 20190201
IS  - 2385-2011 (Electronic)
IS  - 1591-0199 (Print)
IS  - 1591-0199 (Linking)
VI  - 24
IP  - 1
DP  - 2018 Feb
TI  - Impact of histological thrombus composition on preinterventional thrombus 
      migration in patients with acute occlusions of the middle cerebral artery.
PG  - 70-75
LID - 10.1177/1591019917733733 [doi]
AB  - Purpose The occurrence of thrombus migration (TM) in middle cerebral arteries 
      (MCAs) prior to mechanical thrombectomy (MT) in patients suffering from acute 
      ischemic strokes is a crucial aspect as TM is associated with lower rates of 
      complete reperfusion and worse clinical outcomes. In this study, we sought to 
      clarify whether histological thrombus composition influences TM. Methods We 
      included 64 patients with acute MCA occlusions who had undergone MT. In 11 of the 
      cases (17.2%) we identified TM prior to the interventions. The extracted clots 
      were collected and histologically examined. The hematoxylin and eosin-stained 
      specimens were quantitatively analyzed in terms of the relative fractions of the 
      main constituents (red and white blood cells and fibrin/platelets). The 
      histologic patterns were correlated with the occurrence of TM. Results Patients 
      in whom TM could be observed were more often treated in a drip-and-ship fashion 
      (90.9% vs 41.5%, p = 0.003). Stroke etiology did not differ between migrated and 
      stable thrombi. A weak tendency for higher RBC and lower F/P content could be 
      observed in thrombi that had migrated when compared with stable thrombi (RBC: 
      median 41% vs 37%, p = 0.022 and F/P: median 54% vs 57%, p = 0.024). When using a 
      cut-off of 60% RBC content for the definition of RBC-rich thrombi, a higher 
      portion of RBC-rich thrombi could be identified in the migrated group as opposed 
      to the stable group (36.4% vs 5.7%, p = 0.003). Conclusion Preinterventional TM 
      may be influenced by the histological thrombus composition in a way that RBC-rich 
      thrombi are more prone to migrate.
FAU - Maegerlein, Christian
AU  - Maegerlein C
AD  - 1 Department of Neuroradiology, 27190 Klinikum rechts der Isar, Technical 
      University of Munich , Munich, Germany.
FAU - Friedrich, Benjamin
AU  - Friedrich B
AD  - 1 Department of Neuroradiology, 27190 Klinikum rechts der Isar, Technical 
      University of Munich , Munich, Germany.
FAU - Berndt, Maria
AU  - Berndt M
AD  - 1 Department of Neuroradiology, 27190 Klinikum rechts der Isar, Technical 
      University of Munich , Munich, Germany.
FAU - Lucia, Kristin Elizabeth
AU  - Lucia KE
AD  - 2 Department of Neurosurgery, 72217 Charite Universitaetsmedizin , Berlin, 
      Germany.
FAU - Schirmer, Lucas
AU  - Schirmer L
AD  - 3 Eli and Edythe Broad Center for Stem Cell Research and Regeneration Medicine, 
      University of California, San Francisco, San Francisco, CA, USA.
AD  - 4 Department of Neurology, 27190 Klinikum rechts der Isar, Technical University 
      of Munich , Munich, Germany.
FAU - Poppert, Holger
AU  - Poppert H
AD  - 4 Department of Neurology, 27190 Klinikum rechts der Isar, Technical University 
      of Munich , Munich, Germany.
FAU - Zimmer, Claus
AU  - Zimmer C
AD  - 1 Department of Neuroradiology, 27190 Klinikum rechts der Isar, Technical 
      University of Munich , Munich, Germany.
FAU - Pelisek, Jaroslav
AU  - Pelisek J
AD  - 5 Clinic of Vascular and Endovascular Surgery, 27190 Klinikum rechts der Isar, 
      Technical University of Munich , Munich, Germany.
FAU - Boeckh-Behrens, Tobias
AU  - Boeckh-Behrens T
AD  - 1 Department of Neuroradiology, 27190 Klinikum rechts der Isar, Technical 
      University of Munich , Munich, Germany.
FAU - Kaesmacher, Johannes
AU  - Kaesmacher J
AD  - 1 Department of Neuroradiology, 27190 Klinikum rechts der Isar, Technical 
      University of Munich , Munich, Germany.
LA  - eng
PT  - Journal Article
DEP - 20171023
PL  - United States
TA  - Interv Neuroradiol
JT  - Interventional neuroradiology : journal of peritherapeutic neuroradiology, 
      surgical procedures and related neurosciences
JID - 9602695
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiography, Digital Subtraction
MH  - Arterial Occlusive Diseases/diagnostic imaging/*surgery
MH  - Cerebral Angiography
MH  - Computed Tomography Angiography
MH  - Erythrocytes
MH  - Female
MH  - Humans
MH  - Infarction, Middle Cerebral Artery/diagnostic imaging/*surgery
MH  - Intracranial Thrombosis/diagnostic imaging/*pathology/*surgery
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Thrombectomy/*methods
PMC - PMC5772536
OTO - NOTNLM
OT  - Stroke
OT  - blood cells
OT  - histology
OT  - thrombus migration
EDAT- 2017/10/24 06:00
MHDA- 2018/07/18 06:00
PMCR- 2019/02/01
CRDT- 2017/10/24 06:00
PHST- 2017/10/24 06:00 [pubmed]
PHST- 2018/07/18 06:00 [medline]
PHST- 2017/10/24 06:00 [entrez]
PHST- 2019/02/01 00:00 [pmc-release]
AID - 10.1177_1591019917733733 [pii]
AID - 10.1177/1591019917733733 [doi]
PST - ppublish
SO  - Interv Neuroradiol. 2018 Feb;24(1):70-75. doi: 10.1177/1591019917733733. Epub 
      2017 Oct 23.