| Objective: By studying the pathological components of emboli in patients with acute ischemic stroke after mechanical thrombectomy,to explore the relationship between thrombus components and the cause of stroke,surgical parameters in the process of thrombectomy and clinical prognosis,so as to guide the prevention and treatment of ischemic stroke.Methods: 55 patients with AIS who underwent mechanical thrombectomy(including bridging therapy)and obtained thromboemboli in Jilin Central Hospital from Sep.2021 to Dec.2022 were collected as subjects.1.The obtained thromboembolic sections were stained with HE,and the components of the thrombus were quantitatively analyzed.The thrombus samples were divided into two groups by calculating the proportion of each component in the embolus.The thromboembolus with the sum ratio of fibrin to platelets ≥ 50%was defined as the fibrin-rich group,and the erythrocyte proportion ≥ 50% was defined as the erythrocyte-rich group.The differences of general clinical data,thrombectomy parameters and prognosis between the two groups were compared.2.The subjects were divided into groups according to the relevant clinical data based on TOAST classification criteria to compare whether the difference of pathological components of thrombus tissue among patients with different clinical types of AIS was statistically significant.Results: A total of 55 patients who met the criteria for admission were included.1.Among the emboli collected in this study,red blood cells accounted for44.2%(24.8%-60.9%),white blood cells accounted for 4.0%(1.7%-4.1%),and fibrin and platelets accounted for 50.0%(33.6%-70.4%).Thrombus was rich in red blood cells in 22 patients and fibrin in 33 patients.There was no significant difference in the general clinical data between the two groups(P>0.05),but there was a significant difference in the causes between the two groups,with a higher proportion of atherosclerotic stroke in the erythrocyte-rich group and a higher proportion of cardiogenic stroke in the fibrin-rich group(P<0.05).There was no significant difference in thrombectomy parameters between the two groups,including bridging vein thrombolysis,anesthesia mode,thrombectomy times,mTICI grade and so on.In terms of prognosis,the decrease of NIHSS score ≥ 4 on the 7th day after operation in the erythrocyte-rich thrombus group was more than that in the fibrin-rich group(68.2% vs 48.5%),but the difference was not statistically significant(P>0.05).90 days after operation,the patients with m RS score 0-2 were more than those in the fibrin-rich group(77.3% vs 45.5%),and the difference was statistically significant.There was no significant difference in the incidence of s ICH,cerebral hernia and death between the two groups(P>0.05).2.2.There was significant difference in the pathological composition of thrombus tissue between patients with atherosclerotic stroke and patients with cardiogenic stroke(P<0.05),and that in patients with cardiogenic stroke was significantly lower than that in patients with large atherosclerosis(39.1% vs48.1%).The difference of the sum of fibrin and platelet components was also statistically significant(P<0.05),and the cardiogenic stroke group was significantly higher than the large atherosclerosis group(55.1% vs 46.2%).There was no significant difference in leukocyte count(P>0.05).In addition,there was no significant difference in thrombus composition between the unexplained stroke group and the other two groups(P>0.05).Conclusion: 1.The composition of thrombus may be related to the cause of acute ischemic stroke.If the thrombus is rich in erythrocytes,the TOAST type is more likely to be atherosclerotic.2.The composition of thrombus may not be related to the operative parameters in the process of mechanical thrombectomy,such as bridging,treatment time,times of thrombectomy,mTICI grade after thrombectomy,etc.3.Patients with higher erythrocyte content in thrombus have a higher proportion of good long-term prognosis than patients with high proportion of fibrin and platelets. |
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