A Study On Clinical Features And Short-term Prognostic Factors Of Acute Ischemic Stroke Patients With Different Thrombus Components

Objective: This study analyzed the components of thrombus in patients with acute ischemic stroke(AIS)undergoing endovascular treatment and explored the differences in demographic information,vascular risk factors,surgical parameters and short-term prognosis between different thrombus components.The factors influencing short-term prognosis were also explored.Methods: The clinical data of 90 patients with acute ischemic stroke undergoing endovascular treatment in Xuzhou Central Hospital Advanced Stroke Center from January 2021 to October 2022 were retrospectively analyzed.The thrombus retained during the operation were analyzed by hematoxylin-eosin(HE)staining.According to the proportion of the area occupied by fibrin/platelet components compared with the sum of the area occupied by red blood cells and white blood cells in the pathological sections of thrombi,the thrombi were divided into high fibrin/platelet thrombus(HF/P)and low fibrin/platelet thrombus(LF/P),namely HF/P group and LF/P group.The demographic information,vascular risk factors,surgical parameters and short-term prognosis were compared between the two groups.Univariate logistic regression and multivariate logistic regression analysis were used to explore the factors influencing the short-term prognosis of endovascular treatment.Results: Initially 90 patients were included in the study.Six cases were excluded due to unsuccessful thrombus staining and other technical reasons.Finally,84 cases were statistically analyzed.The grouping was as follows: 38 cases in the HF/P group and 46 cases in the LF/P group.The short-term prognosis grouping was as follows: 26 cases with good short-term prognosis and 58 cases with poor short-term prognosis.The differences in responsibly occluded blood vessels(P=0.002),number of thrombus retrievals(P=0.006)and short-term prognosis(P=0.015)were statistically significant between the two groups.Univariate analysis of short-term prognosis showed that history of hypertension(P=0.034),preoperative NIHSS score(P=0.004),operation time(P=0.002),number of thrombus retrievals(P=0.011)and thrombus component(P=0.015)affected the short-term prognosis of patients with AIS.After correcting other factors influencing prognosis,multivariate logistic regression analysis showed that preoperative NIHSS score and thrombus component were independent factors influencing the short-term prognosis of AIS patients undergoing endovascular treatment.Conclusion: Different thrombus components were associated with differences in vascular risk factors,surgical parameters,short-term prognosis and other clinical characteristics in patients with acute ischemic stroke.Moreover,thrombus component affected the short-term prognosis of AIS patients undergoing endovascular treatment.