Development of a predictive scale for cardioembolic stroke using extracted thrombi and angiographic findings

Publication date: Available online 19 February 2020Source: Journal of Clinical NeuroscienceAuthor(s): Bomi Kim, Yeon Mee Kim, Sung-cheol Jin, Jun-won Lee, Byung In Lee, Sung Eun Kim, Kyong Jin Shin, JinSe Park, Kang Min Park, Si Eun Kim, Seongho Park, Sam Yeol HaAbstractWe analyzed the histopathological findings of the clots obtained from patients with acute ischemic stroke by mechanical thrombectomy. We then developed a clinical scoring system for predicting pathogenic causes in patients with undetermined ischemic stroke using these histopathological and the angiographic findings during endovascular treatment. Only cases with the occlusion of the intracranial internal carotid artery or the proximal part of the middle cerebral artery were included in this study. Histopathologic findings of clots were compared and analyzed using the Trial of Org 10,172 in Acute Stroke Treatment (TOAST; large artery atherosclerosis, cardioembolic, and undetermined groups) and angiographic occlusion type (AOT; branching-site occlusion and truncal-type occlusion groups) classification systems. Fifty-two patients had enough clots extracted by mechanical thrombectomy for full histopathologic examination. There was no significant within-group difference in the fraction of components in the thrombi for either the TOAST or AOT system; however, the platelet distribution patterns were different. The large artery atherosclerotic group and truncal-type occlusion group had mostly peripheral patterns, where...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research