Aims and objectives
Although IV thrombolysis results have shown to be related to thrombus length,
we don't have so much information about thrombus length influence on recanalization rate and neurological outcome after mechanical thrombectomy with stent retrievers.
We analyzed thrombus length in order to try to find correlation between thrombus length in both NECT and angiographic techniques (CTA,
successful recanalization and neurological outcome after after 3 months in patients treated mechanical thrombectomy with stent retrievers.
Methods and materials
We evaluated NECT and angiographic techniques from 79 consecutive patients suffering a stroke with MCA occlusion treated with mechanical thrombectomy with stentretrievers.
Pearson correlation coefficient was estimated to evaluate the association between thrombus length measured by CT and angio.
Bland & Altman plot was drawn to obtain a visual way of assessing agreement between the two measures.
Univariate analysis through U Mann-Whitney to estimate association between thrombus length and successful recanalization and modified Rankin Scale (mRS).
Significance level was fixed at 0.05.
We used Stata...
Mean thrombus length in NECT was 12.6 mm (IQR 9.1-18.9),
with no differences between succesful recanalization from those with a failure in recanalization (12.3 vs 14 mm,
Mean thrombus length inangiographic techniques (CTA) was 13.6 mm (IQR 10.2-23),
with no differences between succesful recanalization from those with a failure in recanalization (12.95 vs 14.35mm,
When concerning about neurological outcome,
we did not found differences between good neurological outcome (mRS 0-2) vs bad neurological outcome (mRS >2) associated with mean thrombus length in NECT...
In our study,
we did not found a relatioship between thrombusand recanalization success or neurological outcome in mechanical thrombectomy for middle cerebral artery occlusions.
large clots should not be a contraindication for mechanical thrombectomy with stent retrievers.
It may be other factors that influence the rate of recanalization (clot density,
clot composition...) or perhaps it is the sum of several of them which has the key for predicting succesful recanalization and neurological outcome.
Thrombus density predicts successful
recanalization with Solitaire stent retriever thrombectomy in acute ischemic stroke.
J Neurointerv Surg 2015;7:104–7.
The importance of size: successful recanalization by intravenous thrombolysis in acute anterior stroke depends on thrombus length.
Thrombus imaging in acute stroke:correlation of thrombus length on susceptibility-weighted imaging with endovascular reperfusion success.
Eur Radiol 2014;24:1735–41.