The diagnostic utility of routine clot analysis after endovascular thrombectomy in a patient with systemic lupus erythematosus and antiphospholipid syndrome

We present a case demonstrating histopathological clot findings after endovascular thrombectomy for acute ischaemic stroke in a 38 year-old male with systemic lupus erythematosus and antiphospholipid syndrome (APS). The differential diagnosis was embolism of a suspected Libman-Sacks vegetation or less likely an in-situ thrombosis. Clot analysis provided guidance with patient management and anticoagulation was commenced. The utility of clot analysis in this case provides support for routine clot analysis, which has been standard practice at our institution, and is likely to evolve as endovascular thrombectomy becomes more widely accessible.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

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Paola Adele Lonati1†, Mariangela Scavone2,3†, Maria Gerosa4, Maria Orietta Borghi1,4, Francesca Pregnolato1, Daniele Curreli1, Gianmarco Podda2,3, Eti Alessandra Femia2,3, Wilma Barcellini5, Marco Cattaneo2,3, Francesco Tedesco1 and Pier Luigi Meroni1* 1Immunorheumatology Research Laboratory, Istituto Auxologico Italiano, IRCCS, Milan, Italy2Unità di Medicina II, ASST Santi Paolo e Carlo, Milan, Italy3Dipartimento di Scienze Della Salute, University of Milan, Milan, Italy4Dipartimento di Scienze Cliniche e di Comunità, University of Milan, Milan, Italy5UOC Ematologia, Fondazione IRCCS Ca&#x...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Rivaroxaban is an effective and safe alternative to warfarin in patients with atrial fibrillation and venous thromboembolism. We tested the efficacy and safety of rivaroxaban compared with warfarin in high-risk patients with thrombotic antiphospholipid syndrome. This is a randomized open-label multicenter noninferiority study with blinded end point adjudication. Rivaroxaban, 20 mg once daily (15 mg once daily based on kidney function) was compared with warfarin (international normalized ratio target 2.5) for the prevention of thromboembolic events, major bleeding, and vascular death in patients with antiphospholipid syndro...
Source: Blood - Category: Hematology Authors: Tags: Plenary Papers, Thrombosis and Hemostasis, Clinical Trials and Observations Source Type: research
Perinatal stroke causes cerebral palsy and lifelong disability. Specific diseases are definable, but mechanisms are poorly understood. Evidence suggests possible associations between arterial perinatal stroke and prothrombotic disorders, but population-based, controlled, disease-specific studies are limited. Understanding thrombophilia in perinatal stroke informs pathogenesis models and clinical management. We conducted a population-based, prospective, case-control study to determine the association of specific perinatal stroke diseases with known thrombophilias. Children with idiopathic magnetic resonance imaging–cl...
Source: Blood - Category: Hematology Authors: Tags: Pediatric Hematology, Free Research Articles, Thrombosis and Hemostasis, Vascular Biology, CME article Source Type: research
CONCLUSION: APS is an independent risk factor for hemorrhagic transformation in both thrombolytic and non-thrombolytic treated patients. APS is also associated with longer length and cost of hospital stay. Further research is warranted to identify the unique risk factors in these patients to identify strategies to reduce the risk of hemorrhagic transformation in this subgroup of the population. PMID: 28475479 [PubMed - as supplied by publisher]
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
Conclusions This study suggest, that in primary APS, persistent negative aPL profile is not an indication to interrupt oral anticoagulant therapy. However, there is a subset of patients that remained asymptomatic. Other studies are necessary in order to elucidate this controversy.
Source: Autoimmunity Reviews - Category: Allergy & Immunology Source Type: research
Publication date: Available online 24 June 2016 Source:Medical Journal Armed Forces India Author(s): R.S. Mallhi, Neerja Kushwaha, T. Chatterjee, J. Philip The antiphospholipid syndrome (APS) is an acquired autoimmune thrombophilic disorder that is characterized by thrombosis (venous, arterial and microvascular) and obstetric morbidity due to a diverse family of antibodies against phospholipid-binding proteins present in plasma. The term antiphospholipid antibody is actually a misnomer as the antibodies are not against the phospholipid per se, but target the plasma protein co-factors, which bind to anionic PLs. The e...
Source: Medical Journal Armed Forces India - Category: Journals (General) Source Type: research
Antiphospholipid syndrome(APS) is an autoimmune disorder. The diagnostic criteria comprise clinical criteria - vascular thrombosis or pregnancy morbidity - together with laboratory criterion: lupus anticoagulant, anticardiolipin(aCL) antibody of immunoglobulin(Ig)G/IgM isotype or anti-β2-glycoprotein-I antibody of IgG/M isotype [1].
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Authors: Sugie M, Iizuka N, Shimizu Y, Ichikawa H Abstract We herein report a case presenting with cerebral venous sinus thrombosis (CVST) associated with primary antiphospholipid syndrome (APS). The patient developed recurrent CVST followed by a hemorrhagic ischemic stroke despite the use of warfarin during the appropriate therapeutic window. Thus, we substituted warfarin to rivaroxaban with prednisolone and obtained a good clinical course. In addition to the effect of prednisolone of inhibiting elevated lupus anticoagulants and the recurrence of arterial thrombosis, rivaroxaban may prevent CVST and inhibit hyperc...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
CONCLUSION: This case report showed the feasibility of mechanical clot retrieval and stent implantation in patients with APS. Due to the elevated risk of in-stent thrombosis a prolonged therapy with glycoprotein (GP)IIb/IIIa receptor antagonists in the initial postoperative period and further anticoagulation with coumarin derivate might be needed. PMID: 26135672 [PubMed - as supplied by publisher]
Source: Interventional Neuroradiology - Category: Radiology Tags: Interv Neuroradiol Source Type: research
The objective of this paper is to describe the development and initial content, criterion and construct validity of a disease-specific cumulative damage index in patients with thrombotic APS (DIAPS). METHODS: Through expert panel agreement, 47 items were considered to reflect damage in APS. This preliminary version of the DIAPS was submitted to four local and international clinical and research experts in APS who ranked each item according to severity. A Delphi exercise resulted in a final 37 item instrument. In the second phase, a cross-sectional study was conducted applying the DIAPS in patients included in a multic...
Source: Lupus - Category: Rheumatology Authors: Tags: Lupus Source Type: research
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