Study On The Correlation Between Thrombosis Pathology And Prognosis Of Endovascular Therapy For Acute Ischemic Stroke

Backgroud: The key to the treatment of acute ischemic stroke is to open occluded blood vessels,restore cerebral blood flow,and reduce the core infarct area as soon as possible.Since 2015 MR CLEAN,ESCAPE,EXTEND-IA,SWIFT PRIME and REVASCAT,these five studies have confirmed the efficacy of acute endovascular therapy.The clinical prognosis of patients with acute ischemic stroke who underwent intravascular treatment of intracranial vascular occlusion is quite different.Some patients recovered well,some patients had disability,and some patients died.The current study found that endovascular therapy manner,bridging treatment,cerebral collateral circulation,NIHSS score,ASPECTS,time window,hemorrhagic transformation and other factors may be correlated with the prognosis of endovascular therapy of acute ischemic stroke.The correlation between thrombopathology and prognosis of endovascular therapy in acute ischemic stroke has not been reported.Objective: To investigate the correlation between thrombosis pathology and prognosis of endovascular therapy for acute ischemic stroke.Methods: 58 consecutive patients with acute ischemic stroke who had acquired cerebral artery thrombosis were enrolled in this study.The thrombus was examined by HE staining.The ratio of erythrocyte and fibrin/platelet components was determined and divided into erythrocyte-rich group(erythrocyte ratio≥70%),mixed group(erythrocyte ratio31-69%)and fibrin/platelet-rich group(erythrocyte ratio≤30%).The good prognosis was defined as 0-2 m RS score at 90 days after operation and 3-6m RS score at adverse prognosis.The patients were divided into good prognosis group and bad prognosis group to analyze the correlation between the pathological type of thrombus.Results: Erythrocyte-rich group was 18.96%(11/58),mixed group was63.79%(37/58),fibrin/platelet group was 17.24%(10/58),the good prognosis was 43.10%(25/58),the bad prognosis was 56.90%(33/58).Erythrocyte ratio of erythrocyte-rich group between good prognosis group and bad prognosis group no statistical difference(P=0.713),the ratio of mixed group between good prognosis group and bad prognosis group no statistical difference(P=0.829),the ratio of fibrin/platelet group between good prognosis group and bad prognosis group no statistical difference(P=0.748).There were significant differences in ASPECTS score at admission(P=0.008),time from femoral artery puncture to recanalization(P=0.016)and alteplase bridging(P=0.012)between good prognosis group and bad prognosis group.Conclusion:There was no correlation between thrombosis pathology and prognosis of endovascular therapy for acute ischemic stroke.