Correlation analysis of thrombotic components with clinical data in patients with large vessel occlusive cerebral infarction
10.3760/cma.j.cn115354-20200417-00285
- VernacularTitle:大血管闭塞性脑梗死的血栓成分与患者临床资料的关联分析
- Author:
Weidong ZHAO
1
;
Xiaoyu NI
;
Jian WU
;
Changsong XU
;
Liao WU
;
Peng ZUO
;
Guihua NI
Author Information
1. 南京医科大学附属淮安第一医院神经内科 223200
- Keywords:
Large-vessel occlusive cerebral infarction;
Thrombus composition;
Clinical data
- From:
Chinese Journal of Neuromedicine
2020;19(11):1122-1127
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relations of thrombotic components with cause of stroke, procedure of mechanical thrombectomy, degrees of vascular recanalization and clinical prognoses in patients with large vessel occlusive cerebral infarction.Methods:One hundred and thirty-eight patients with large vessel occlusive cerebral infarction accepted mechanical thrombectomy using stent retriever and/or aspiration catheter in our hospital from January 2018 to January 2020 were chosen. These patients were divided into two groups, a erythrocyte-rich group and a fibrin-rich group, based on the predominant composition in the clots. The baseline clinical data, procedure time, number of recanalization maneuvers, degrees of vascular recanalization and clinical prognoses were compared between the two groups. The relations of infiltration degrees of erythrocytes and fibrin in embolus with procedure time were investigated.Results:The components of thrombus clots were mainly erythrocytes, fibrin, leukocytes, and platelets; erythrocyte-rich clots were presented in 59 patients, and fibrin-rich clots were presented in 79 patients. There was no significant difference in age, gender, preoperative NIHSS scores, proportions of hypertension, proportion of diabetes and proportion of vascular recanalization between the two groups ( P>0.05). As compared with patients from erythrocyterich group, patients in the fibrin-rich group had significantly higher proportion of cardioembolic thrombus (22.8% vs. 77.2%), statically larger number of recanalization maneuvers (2 [1, 2] times vs. 3 [2, 4] times), significantly longer procedure times (45 [30, 60] min vs. 80 [60, 90] min), and significantly lower proportion of patients with modifed Rankin scale (mRS) scores≤2 90 d after surgery (62.7% vs. 39.2%, P<0.05). Procedure time was negatively correlated with erythrocyte infiltration ( r= -0.562, P=0.005) and positively correlated with fibrin infiltration ( r=0.567, P=0.010). Conclusions:Different components of thrombus suggest the etiology of stroke may be different. Thrombus removal is relatively easy in patients with erythrocyte-rich clots, and the clinical prognosis is relatively good.
