Relation of thrombus composition with stroke etiology and influence of thrombus composition in prognoses of stroke / 中华神经医学杂志

ABSTRACT

Objective:The composition of thrombi obtained during mechanical thrombectomy in patients with acute ischemic stroke is analyzed to investigate its relation with stroke etiology and its influence in surgical parameters and clinical prognoses.Methods:The thrombi and clinical data of 41 patients with acute ischemic stroke directly treated by mechanical thrombectomy in our hospital from January 2019 to December 2019 were collected. Hematoxylin-eosin (HE) staining was used to quantitatively analyze the composition of thrombi, and the components of thrombi in patients with different causes of stroke (large artery atherosclerosis [LAA], cardiogenic embolism [CE], and unexplained type) were compared. These patients were divided into erythrocyte-rich group (erythrocyte content>fibrin content) and fibrin-rich group (erythrocyte content<fibrin content) according to thrombus composition, and surgical parameters and clinical prognoses were compared between patients from the two groups.Results:(1) The erythrocyte content in the thrombus of stoke patients with LAA, CE, and unexplained type was 52.1%, 39.6%, and 44.4%, respectively, with significant differences ( χ2=3.763, P=0.032); and that in stoke patients with LAA was significantly increased than that in stoke patients with CE ( P<0.05). (2) As compared with the fibrin-rich group, the erythrocyte-rich group has significantly shorter procedure time and significantly smaller times of thrombectomy ( P<0.05). There were no statistically significant differences in National Institutes of Health Stroke Scale (NIHSS) scores, vascular recanalization rate, postoperative cerebral hemorrhage rate, good prognosis rate and mortality rate 90 d after mechanical thrombectomy between the two groups ( P>0.05). Conclusion:Thrombus composition has influence in surgical parameters, but no influence in clinical prognoses.