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Published on: June 2, 2015
Correlation between Thrombus Perviousness and Distal Embolization during Mechanical Thrombectomy in Acute Stroke
Fabio Pilato1,2, Iacopo Valente3, Andrea M Alexandre3
1Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology and Psichiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 00128 Roma, Italy.
Reduced thrombus perviousness, measured by multiphase computed tomography angiography (mCTA), is linked to a higher risk of distal embolization in acute ischemic stroke patients. This imaging biomarker may aid in predicting risks during mechanical thrombectomy.
Area of Science:
- Neurology
- Radiology
- Biomedical Engineering
Background:
- Thrombus permeability influences outcomes in stroke patients undergoing reperfusion.
- Assessing clot characteristics is crucial for predicting treatment success.
Purpose of the Study:
- To determine if thrombus perviousness, assessed via mCTA, correlates with the risk of distal embolization.
- To investigate imaging biomarkers for predicting embolic events in stroke.
Main Methods:
- Analyzed data from 100 acute ischemic stroke (AIS) patients with M1 middle cerebral artery (MCA) occlusion undergoing mechanical thrombectomy.
- Calculated thrombus average attenuation (dHU) on NCCT and clot perviousness on mCTA (arterial and delayed phases).
Main Results:
- Lower perviousness (pre-post1) was associated with distal embolization (p=0.05).
- Thrombus perviousness on mCTA (OR 0.66) and contact aspiration (OR 0.39) were protective factors against distal embolization.
- Reduced perviousness indicates increased distal embolization risk.
Conclusions:
- Thrombus perviousness evaluated by mCTA is associated with distal embolization risk.
- Perviousness may serve as a valuable neuroimaging biomarker for predicting distal embolization during mechanical thrombectomy.
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