[Exploration of thrombus histological composition and clinical effect in mechanical thrombectomy of acute ischemic stroke]

Zhonghua Yi Xue Za Zhi. 2018 Dec 4;98(45):3697-3700. doi: 10.3760/cma.j.issn.0376-2491.2018.45.013.
[Article in Chinese]

Abstract

Objective: To explore histological composition of thrombus and clinical effect in mechanical thrombectomy of acute ischemic stroke. Methods: From March 2017 to August 2017 at the Institutes of Biology and Medical Sciences of Soochow University, hematoxylin and eosin (HE) staining was used to quantitatively analyze the composition of thrombus in 58 cases with acute ischemic stroke. The differences in components of thrombus with different TOAST classifications were compared, meanwhile, clinical data such as surgical process and prognosis were also analyzed. Results: (1) Baseline data: the age of arteriosclerosis was significantly lower than that of cardiogenic (P<0.05). There was statistically significant differences in onset to admission between the two types of stroke of other undetermined etiology (SUE) and Cardioembolism (CE) (P<0.05). (2) Histological composition of thrombus: there were no significant differences in fibrin and red blood cells (RBC) between the two types of SUE and CE thrombus (P>0.05). There were more RBC in LAA thrombus and more fibrin in CE thrombus (P<0.05). (3) Intraoperative data: the time of admission to recanalization of type LAA was longer than that of type CE (P<0.05). (4) Prognosis: there was no significant difference in the good prognosis between the two types of SUE and CE (P>0.05). It is the same between the types of LAA and CE (P>0.05). Conclusions: LAA thrombus contains more RBC, and cardiogenic thrombus contains more fibrin. Cryptogenic thrombus has the same composition with cardioembolism. The results may help to choose appropriate recanalization technique in different TOAST stroke and have guiding significance for the secondary prevention of SUE stroke.

目的: 分析不同病因引发的急性缺血性卒中血栓的组成特征及其对临床疗效的影响。 方法: 收集2017年3至8月在江苏省常州市第一人民医院通过机械取栓获得的血栓标本58例,58例中大动脉粥样硬化组17例,心源组31例,不明原因组10例。通过苏木精-伊红(HE)染色,定量分析急性缺血性卒中大血管闭塞患者脑内血栓的组成。 结果: (1)血栓分析:不明原因组与心源组的血栓成分相似,纤维蛋白原和红细胞含量分别为(53%比54%;47%比46%, P=0.732);心源组与大动脉硬化组血栓成分相比,纤维蛋白原含量明显高(54%比42.0%,P<0.001),而红细胞含量明显低(46%比58.0%,P<0.001)。(2)临床预后:不明原因组、动脉粥样硬化组与心源型组在预后良好方面差异无统计学意义(P>0.05)。 结论: 大动脉硬化组血栓富含红细胞,心源组血栓富含纤维蛋白原;不明原因组血栓成分上与心源性相似。血栓成分对急性缺血性卒中不同病因的再通技术选择和不明原因型卒中的二级预防有一定的指导意义。.

Keywords: Cerebral thrombus; Histology composition; Prognosis.

MeSH terms

  • Brain Ischemia*
  • Fibrin
  • Humans
  • Stroke*
  • Thrombectomy
  • Thrombosis

Substances

  • Fibrin