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Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke

BACKGROUND AND PURPOSE: Mechanical properties of thromboemboli play an important role in the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke. However, very limited data on mechanical properties of human stroke thrombi are available. We aimed to mechanically characterize thrombi...

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Autores principales: Boodt, Nikki, Snouckaert van Schauburg, Philip R.W., Hund, Hajo M., Fereidoonnezhad, Behrooz, McGarry, J. Patrick, Akyildiz, Ali C., van Es, Adriaan C.G.M., De Meyer, Simon F., Dippel, Diederik W.J., Lingsma, Hester F., van Beusekom, Heleen M.M., van der Lugt, Aad, Gijsen, Frank J.H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312567/
https://www.ncbi.nlm.nih.gov/pubmed/34078112
http://dx.doi.org/10.1161/STROKEAHA.120.033527
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author Boodt, Nikki
Snouckaert van Schauburg, Philip R.W.
Hund, Hajo M.
Fereidoonnezhad, Behrooz
McGarry, J. Patrick
Akyildiz, Ali C.
van Es, Adriaan C.G.M.
De Meyer, Simon F.
Dippel, Diederik W.J.
Lingsma, Hester F.
van Beusekom, Heleen M.M.
van der Lugt, Aad
Gijsen, Frank J.H.
author_facet Boodt, Nikki
Snouckaert van Schauburg, Philip R.W.
Hund, Hajo M.
Fereidoonnezhad, Behrooz
McGarry, J. Patrick
Akyildiz, Ali C.
van Es, Adriaan C.G.M.
De Meyer, Simon F.
Dippel, Diederik W.J.
Lingsma, Hester F.
van Beusekom, Heleen M.M.
van der Lugt, Aad
Gijsen, Frank J.H.
author_sort Boodt, Nikki
collection PubMed
description BACKGROUND AND PURPOSE: Mechanical properties of thromboemboli play an important role in the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke. However, very limited data on mechanical properties of human stroke thrombi are available. We aimed to mechanically characterize thrombi retrieved with EVT, and to assess the relationship between thrombus composition and thrombus stiffness. METHODS: Forty-one thrombi from 19 patients with acute stroke who underwent EVT between July and October 2019 were mechanically analyzed, directly after EVT. We performed unconfined compression experiments and determined tangent modulus at 75% strain (E(t75)) as a measure for thrombus stiffness. Thrombi were histologically analyzed for fibrin/platelets, erythrocytes, leukocytes, and platelets, and we assessed the relationship between histological components and E(t75) with univariable and multivariable linear mixed regression. RESULTS: Median E(t75) was 560 (interquartile range, 393–1161) kPa. In the multivariable analysis, fibrin/platelets were associated with increased E(t75) (aβ, 9 [95% CI, 5 to 13]) kPa, erythrocytes were associated with decreased E(t75%) (aβ, −9 [95% CI, −5 to −13]) kPa. We found no association between leukocytes and E(t75). High platelet values were strongly associated with increased E(t75) (aβ, 56 [95% CI, 38–73]). CONCLUSIONS: Fibrin/platelet content of thrombi retrieved with EVT for acute ischemic stroke is strongly associated with increased thrombus stiffness. For thrombi with high platelet values, there was a very strong relationship with thrombus stiffness. Our data provide a basis for future research on the development of next-generation EVT devices tailored to thrombus composition.
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spelling pubmed-83125672021-08-02 Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke Boodt, Nikki Snouckaert van Schauburg, Philip R.W. Hund, Hajo M. Fereidoonnezhad, Behrooz McGarry, J. Patrick Akyildiz, Ali C. van Es, Adriaan C.G.M. De Meyer, Simon F. Dippel, Diederik W.J. Lingsma, Hester F. van Beusekom, Heleen M.M. van der Lugt, Aad Gijsen, Frank J.H. Stroke Original Contributions BACKGROUND AND PURPOSE: Mechanical properties of thromboemboli play an important role in the efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke. However, very limited data on mechanical properties of human stroke thrombi are available. We aimed to mechanically characterize thrombi retrieved with EVT, and to assess the relationship between thrombus composition and thrombus stiffness. METHODS: Forty-one thrombi from 19 patients with acute stroke who underwent EVT between July and October 2019 were mechanically analyzed, directly after EVT. We performed unconfined compression experiments and determined tangent modulus at 75% strain (E(t75)) as a measure for thrombus stiffness. Thrombi were histologically analyzed for fibrin/platelets, erythrocytes, leukocytes, and platelets, and we assessed the relationship between histological components and E(t75) with univariable and multivariable linear mixed regression. RESULTS: Median E(t75) was 560 (interquartile range, 393–1161) kPa. In the multivariable analysis, fibrin/platelets were associated with increased E(t75) (aβ, 9 [95% CI, 5 to 13]) kPa, erythrocytes were associated with decreased E(t75%) (aβ, −9 [95% CI, −5 to −13]) kPa. We found no association between leukocytes and E(t75). High platelet values were strongly associated with increased E(t75) (aβ, 56 [95% CI, 38–73]). CONCLUSIONS: Fibrin/platelet content of thrombi retrieved with EVT for acute ischemic stroke is strongly associated with increased thrombus stiffness. For thrombi with high platelet values, there was a very strong relationship with thrombus stiffness. Our data provide a basis for future research on the development of next-generation EVT devices tailored to thrombus composition. Lippincott Williams & Wilkins 2021-06-03 2021-08 /pmc/articles/PMC8312567/ /pubmed/34078112 http://dx.doi.org/10.1161/STROKEAHA.120.033527 Text en © 2021 The Authors. https://creativecommons.org/licenses/by-nc-nd/4.0/Stroke is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc. This is an open access article under the terms of the Creative Commons Attribution Non-Commercial-NoDerivs (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use, distribution, and reproduction in any medium, provided that the original work is properly cited, the use is noncommercial, and no modifications or adaptations are made.
spellingShingle Original Contributions
Boodt, Nikki
Snouckaert van Schauburg, Philip R.W.
Hund, Hajo M.
Fereidoonnezhad, Behrooz
McGarry, J. Patrick
Akyildiz, Ali C.
van Es, Adriaan C.G.M.
De Meyer, Simon F.
Dippel, Diederik W.J.
Lingsma, Hester F.
van Beusekom, Heleen M.M.
van der Lugt, Aad
Gijsen, Frank J.H.
Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
title Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
title_full Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
title_fullStr Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
title_full_unstemmed Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
title_short Mechanical Characterization of Thrombi Retrieved With Endovascular Thrombectomy in Patients With Acute Ischemic Stroke
title_sort mechanical characterization of thrombi retrieved with endovascular thrombectomy in patients with acute ischemic stroke
topic Original Contributions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8312567/
https://www.ncbi.nlm.nih.gov/pubmed/34078112
http://dx.doi.org/10.1161/STROKEAHA.120.033527
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