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Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke
BACKGROUND AND PURPOSE: The aim of this study was to investigate the efficacy of thrombus density on noninvasive computed tomography (CT) neuroimaging for predicting thrombus pathology and patient outcome after mechanical thrombectomy in acute ischemic stroke. MATERIALS AND METHODS: This retrospecti...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702996/ https://www.ncbi.nlm.nih.gov/pubmed/31497104 http://dx.doi.org/10.4103/ajns.AJNS_238_18 |
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author | Songsaeng, Dittapong Kaeowirun, Tharathorn Sakarunchai, Ittichai Cheunsuchon, Pornsuk Weankhanan, Jaruwan Suwanbundit, Anek Krings, Timo |
author_facet | Songsaeng, Dittapong Kaeowirun, Tharathorn Sakarunchai, Ittichai Cheunsuchon, Pornsuk Weankhanan, Jaruwan Suwanbundit, Anek Krings, Timo |
author_sort | Songsaeng, Dittapong |
collection | PubMed |
description | BACKGROUND AND PURPOSE: The aim of this study was to investigate the efficacy of thrombus density on noninvasive computed tomography (CT) neuroimaging for predicting thrombus pathology and patient outcome after mechanical thrombectomy in acute ischemic stroke. MATERIALS AND METHODS: This retrospective chart and imaging review included patients that were treated by mechanical thrombectomy at Siriraj Hospital according to the American Heart Association/American Stroke Association guidelines for the early management of patients with acute ischemic stroke from March 2010 to February 2015 study period. Preintervention noncontrast CT (NCCT), CT angiography (CTA), and/or contrast-enhanced CT (CECT) images were interpreted using CT densitometry. Pathology results were classified as white, red, or mixed thrombi. The result of treatment was evaluated by the modified Rankin Scale at 90 days after treatment. RESULTS: From 97 included patients – 97 NCCT images, 48 CTA images, 48 CECT images, and 54 pathologic results of cerebral thrombi were included in the final analysis. Mean clot Hounsfield unit values on NCCT, CTA, and CECT were significantly different between red and white thrombus (P = 0.001 on NCCT, P = 0.03 on CTA, and P = 0.001 on CECT), and between red and mixed thrombus (P = 0.043 on NCCT and P = 0.002 on CTA). However, no significant difference was observed between white thrombus and mixed thrombus (P = 0.09 on NCCT, P = 1.00 on CTA, and P = 0.054 on CECT). There was no significant correlation between type of cerebral thrombus or clot density and the result of treatment. CONCLUSION: Thrombus density on CT was found to be a significant predictor of thrombus pathology; however, no significant association was observed between thrombus type or clot density and patient outcome after mechanical thrombectomy. |
format | Online Article Text |
id | pubmed-6702996 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-67029962019-09-06 Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke Songsaeng, Dittapong Kaeowirun, Tharathorn Sakarunchai, Ittichai Cheunsuchon, Pornsuk Weankhanan, Jaruwan Suwanbundit, Anek Krings, Timo Asian J Neurosurg Original Article BACKGROUND AND PURPOSE: The aim of this study was to investigate the efficacy of thrombus density on noninvasive computed tomography (CT) neuroimaging for predicting thrombus pathology and patient outcome after mechanical thrombectomy in acute ischemic stroke. MATERIALS AND METHODS: This retrospective chart and imaging review included patients that were treated by mechanical thrombectomy at Siriraj Hospital according to the American Heart Association/American Stroke Association guidelines for the early management of patients with acute ischemic stroke from March 2010 to February 2015 study period. Preintervention noncontrast CT (NCCT), CT angiography (CTA), and/or contrast-enhanced CT (CECT) images were interpreted using CT densitometry. Pathology results were classified as white, red, or mixed thrombi. The result of treatment was evaluated by the modified Rankin Scale at 90 days after treatment. RESULTS: From 97 included patients – 97 NCCT images, 48 CTA images, 48 CECT images, and 54 pathologic results of cerebral thrombi were included in the final analysis. Mean clot Hounsfield unit values on NCCT, CTA, and CECT were significantly different between red and white thrombus (P = 0.001 on NCCT, P = 0.03 on CTA, and P = 0.001 on CECT), and between red and mixed thrombus (P = 0.043 on NCCT and P = 0.002 on CTA). However, no significant difference was observed between white thrombus and mixed thrombus (P = 0.09 on NCCT, P = 1.00 on CTA, and P = 0.054 on CECT). There was no significant correlation between type of cerebral thrombus or clot density and the result of treatment. CONCLUSION: Thrombus density on CT was found to be a significant predictor of thrombus pathology; however, no significant association was observed between thrombus type or clot density and patient outcome after mechanical thrombectomy. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6702996/ /pubmed/31497104 http://dx.doi.org/10.4103/ajns.AJNS_238_18 Text en Copyright: © 2019 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Songsaeng, Dittapong Kaeowirun, Tharathorn Sakarunchai, Ittichai Cheunsuchon, Pornsuk Weankhanan, Jaruwan Suwanbundit, Anek Krings, Timo Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke |
title | Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke |
title_full | Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke |
title_fullStr | Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke |
title_full_unstemmed | Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke |
title_short | Efficacy of Thrombus Density on Noninvasive Computed Tomography Neuroimaging for Predicting Thrombus Pathology and Patient Outcome after Mechanical Thrombectomy in Acute Ischemic Stroke |
title_sort | efficacy of thrombus density on noninvasive computed tomography neuroimaging for predicting thrombus pathology and patient outcome after mechanical thrombectomy in acute ischemic stroke |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6702996/ https://www.ncbi.nlm.nih.gov/pubmed/31497104 http://dx.doi.org/10.4103/ajns.AJNS_238_18 |
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