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Abbasi M, Kvamme P, Layton KF, Hanel RA, Almekhlafi MA, Delgado JE, Pereira VM, Patel BM, Jahromi BS, Yoo AJ, Nogueira RG, Gounis MJ, Fitzgerald S, Mereuta OM, Dai D, Kadirvel R, Kallmes DF, Doyle KM, Savastano LE, Cloft HJ, Liu Y, Thacker IC, Aghaebrahim A, Sauvageau E, Demchuk AM, Kayan Y, Copelan AZ, Entwistle J, Nazari P, Cantrell DR, Bhuva P, Soomro J, Haussen DC, Al-Bayati A, Mohammaden M, Pisani L, Rodrigues G, Puri AS, Brinjikji W. Per pass analysis of thrombus composition retrieved by mechanical thrombectomy. Interv Neuroradiol 2021; 27:815-820. [PMID: 33823621 DOI: 10.1177/15910199211009119] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND AIM Mechanical thrombectomy (MT) for large vessel occlusion often requires multiple passes to retrieve the entire thrombus load. In this multi-institutional study we sought to examine the composition of thrombus fragments retrieved with each pass during MT. METHODS Patients who required multiple passes during thrombectomy were included. Histopathological evaluation of thrombus fragments retrieved from each pass was performed using Martius Scarlet Blue staining and the composition of each thrombus component including RBC, fibrin and platelet was determined using image analysis software. RESULTS 154 patients underwent MT and 868 passes was performed which resulted in 263 thrombus fragments retrieval. The analysis of thrombus components per pass showed higher RBC, lower fibrin and platelet composition in the pass 1 and 2 when compared to pass 3 and passes 4 or more combined (P values <0.05). There were no significant differences between thrombus fragments retrieved in pass 1 and pass 2 in terms of RBC, WBC, fibrin, and platelet composition (P values >0.05). Similarly, when each composition of thrombus fragments retrieved in pass 3 and passes 4 or more combined were compared with each other, no significant difference was noted (P values >0.05). CONCLUSION Our findings confirm that thrombus fragments retrieved with each pass differed significantly in histological content. Fragments in the first passes were associated with lower fibrin and platelet composition compared to fragments retrieved in passes three and four or higher. Also, thrombus fragments retrieved after failed pass were associated with higher fibrin and platelet components.
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Affiliation(s)
- Mehdi Abbasi
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Peter Kvamme
- Department of Radiology, University of Tennessee Medical Center, Knoxville, TN, USA
| | - Kennith F Layton
- Department of Radiology, Baylor University Medical Center, Dallas, TX, USA
| | - Ricardo A Hanel
- Department of Neurosurgery, Baptist Medical Center, Jacksonville, FL, USA
| | - Mohammed A Almekhlafi
- Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Josser E Delgado
- NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Vitor M Pereira
- Departments of Medical Imaging and Surgery, Toronto Western Hospital, Toronto, ON, Canada
| | - Biraj M Patel
- Departments of Radiology and Neurosurgery, Carilion Clinic, Roanoke, VA, USA
| | - Babak S Jahromi
- Departments of Radiology and Neurosurgery, Northwestern University, Chicago, IL, USA
| | - Albert J Yoo
- Department of Neurointervention, Texas Stroke Institute, Plano, TX, USA
| | - Raul G Nogueira
- Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, GA, USA
| | - Matthew J Gounis
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts, Worcester, MA, USA
| | - Seán Fitzgerald
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - Oana M Mereuta
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - Daying Dai
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - David F Kallmes
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Karen M Doyle
- Department of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland
| | - Luis E Savastano
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Harry J Cloft
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Yang Liu
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Ike C Thacker
- Department of Radiology, Baylor University Medical Center, Dallas, TX, USA
| | - Amin Aghaebrahim
- Department of Neurosurgery, Baptist Medical Center, Jacksonville, FL, USA
| | - Eric Sauvageau
- Department of Neurosurgery, Baptist Medical Center, Jacksonville, FL, USA
| | - Andrew M Demchuk
- Departments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Yasha Kayan
- NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - Alexander Z Copelan
- NeuroInterventional Radiology, Abbott Northwestern Hospital, Minneapolis, MN, USA
| | - John Entwistle
- Departments of Radiology and Neurosurgery, Carilion Clinic, Roanoke, VA, USA
| | - Pouya Nazari
- Departments of Radiology and Neurosurgery, Northwestern University, Chicago, IL, USA
| | | | - Parita Bhuva
- Department of Neurointervention, Texas Stroke Institute, Plano, TX, USA
| | - Jazba Soomro
- Department of Neurointervention, Texas Stroke Institute, Plano, TX, USA
| | - Diogo C Haussen
- Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, GA, USA
| | - Alhamza Al-Bayati
- Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, GA, USA
| | - Mahmoud Mohammaden
- Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, GA, USA
| | - Leonardo Pisani
- Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, GA, USA
| | - Gabriel Rodrigues
- Department of Neurology, Grady Memorial Hospital and Emory University, Atlanta, GA, USA
| | - Ajit S Puri
- Department of Radiology, New England Center for Stroke Research, University of Massachusetts, Worcester, MA, USA
| | - Waleed Brinjikji
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
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