Abstract
Background and Purpose- Nearly 30% of large vessel occlusion acute ischemic stroke clots are from an unknown source. We assessed histological clot composition in a series of patients with large vessel occlusion and investigated correlations between clot composition and stroke pathogenesis. Methods- As part of the multi-institutional STRIP registry (Stroke Thromboembolism Registry of Imaging and Pathology), consecutive emboli retrieved during mechanical thrombectomy were stained using Martius Scarlett Blue and analyzed using machine learning software. We assessed proportions of red blood cells, fibrin, platelets, and white blood cells. Correlations between clot components and stroke pathogenesis (large artery atherosclerosis, cardioembolism, and stroke of undetermined pathogenesis) were assessed using SPSS22. Results- One hundred five patients were included. The proportion of platelet-rich clots (55.0% versus 21.2%; P=0.005) and percentage of platelet content (22.1±4.2% versus 13.9±14.2%; P=0.03) was significantly higher in the large artery atherosclerosis group compared with the cardioembolic group. The proportion of platelet-rich clots (50.0% versus 21.2%; P=0.024) was also significantly higher in the cryptogenic group compared with cardioembolic cases. Large artery atherosclerosis and cryptogenic cases had a similar proportion of platelet-rich clots (55.0% versus 50.0%; P=0.636). There was no significant difference between stroke pathogenesis and the other major clot components. Conclusions- High platelet content of emboli is associated with a large artery atherosclerosis etiology of large vessel occlusion.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1907-1910 |
| Number of pages | 4 |
| Journal | Stroke |
| Volume | 50 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2019 |
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Keywords
- arteries
- blood platelets
- fibrin
- humans
- software
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Advanced and Specialized Nursing
Cite this
Platelet-Rich Emboli in Cerebral Large Vessel Occlusion Are Associated With a Large Artery Atherosclerosis Source. / Fitzgerald, Seán; Dai, Daying; Wang, Shunli; Douglas, Andrew; Kadirvel, Ramanathan; Layton, Kennith F.; Thacker, Ike C.; Gounis, Matthew J.; Chueh, Ju Yu; Puri, Ajit S.; Almekhlafi, Mohammed; Demchuk, Andrew M.; Hanel, Ricardo A.; Sauvageau, Eric; Aghaebrahim, Amin; Yoo, Albert J.; Kvamme, Peter; M Pereira, Vitor; Kayan, Yasha; Delgado Almandoz, Josser E.; Nogueira, Raul G.; Rabinstein, Alejandro A.; Kallmes, David F.; Doyle, Karen M.; Brinjikji, Waleed.
In: Stroke, Vol. 50, No. 7, 01.07.2019, p. 1907-1910.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Platelet-Rich Emboli in Cerebral Large Vessel Occlusion Are Associated With a Large Artery Atherosclerosis Source
AU - Fitzgerald, Seán
AU - Dai, Daying
AU - Wang, Shunli
AU - Douglas, Andrew
AU - Kadirvel, Ramanathan
AU - Layton, Kennith F.
AU - Thacker, Ike C.
AU - Gounis, Matthew J.
AU - Chueh, Ju Yu
AU - Puri, Ajit S.
AU - Almekhlafi, Mohammed
AU - Demchuk, Andrew M.
AU - Hanel, Ricardo A.
AU - Sauvageau, Eric
AU - Aghaebrahim, Amin
AU - Yoo, Albert J.
AU - Kvamme, Peter
AU - M Pereira, Vitor
AU - Kayan, Yasha
AU - Delgado Almandoz, Josser E.
AU - Nogueira, Raul G.
AU - Rabinstein, Alejandro A.
AU - Kallmes, David F.
AU - Doyle, Karen M.
AU - Brinjikji, Waleed
PY - 2019/7/1
Y1 - 2019/7/1
N2 - Background and Purpose- Nearly 30% of large vessel occlusion acute ischemic stroke clots are from an unknown source. We assessed histological clot composition in a series of patients with large vessel occlusion and investigated correlations between clot composition and stroke pathogenesis. Methods- As part of the multi-institutional STRIP registry (Stroke Thromboembolism Registry of Imaging and Pathology), consecutive emboli retrieved during mechanical thrombectomy were stained using Martius Scarlett Blue and analyzed using machine learning software. We assessed proportions of red blood cells, fibrin, platelets, and white blood cells. Correlations between clot components and stroke pathogenesis (large artery atherosclerosis, cardioembolism, and stroke of undetermined pathogenesis) were assessed using SPSS22. Results- One hundred five patients were included. The proportion of platelet-rich clots (55.0% versus 21.2%; P=0.005) and percentage of platelet content (22.1±4.2% versus 13.9±14.2%; P=0.03) was significantly higher in the large artery atherosclerosis group compared with the cardioembolic group. The proportion of platelet-rich clots (50.0% versus 21.2%; P=0.024) was also significantly higher in the cryptogenic group compared with cardioembolic cases. Large artery atherosclerosis and cryptogenic cases had a similar proportion of platelet-rich clots (55.0% versus 50.0%; P=0.636). There was no significant difference between stroke pathogenesis and the other major clot components. Conclusions- High platelet content of emboli is associated with a large artery atherosclerosis etiology of large vessel occlusion.
AB - Background and Purpose- Nearly 30% of large vessel occlusion acute ischemic stroke clots are from an unknown source. We assessed histological clot composition in a series of patients with large vessel occlusion and investigated correlations between clot composition and stroke pathogenesis. Methods- As part of the multi-institutional STRIP registry (Stroke Thromboembolism Registry of Imaging and Pathology), consecutive emboli retrieved during mechanical thrombectomy were stained using Martius Scarlett Blue and analyzed using machine learning software. We assessed proportions of red blood cells, fibrin, platelets, and white blood cells. Correlations between clot components and stroke pathogenesis (large artery atherosclerosis, cardioembolism, and stroke of undetermined pathogenesis) were assessed using SPSS22. Results- One hundred five patients were included. The proportion of platelet-rich clots (55.0% versus 21.2%; P=0.005) and percentage of platelet content (22.1±4.2% versus 13.9±14.2%; P=0.03) was significantly higher in the large artery atherosclerosis group compared with the cardioembolic group. The proportion of platelet-rich clots (50.0% versus 21.2%; P=0.024) was also significantly higher in the cryptogenic group compared with cardioembolic cases. Large artery atherosclerosis and cryptogenic cases had a similar proportion of platelet-rich clots (55.0% versus 50.0%; P=0.636). There was no significant difference between stroke pathogenesis and the other major clot components. Conclusions- High platelet content of emboli is associated with a large artery atherosclerosis etiology of large vessel occlusion.
KW - arteries
KW - blood platelets
KW - fibrin
KW - humans
KW - software
UR - http://www.scopus.com/inward/record.url?scp=85068810143&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85068810143&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.118.024543
DO - 10.1161/STROKEAHA.118.024543
M3 - Article
C2 - 31138084
AN - SCOPUS:85068810143
VL - 50
SP - 1907
EP - 1910
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 7
ER -