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BMC Neurology

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Open Access 01-12-2020 | Stroke | Research article

Clot composition of embolic strokes of undetermined source: a feasibility study

Authors: Amre Nouh, Tapan Mehta, Mohamed Hussain, Xianyuan Song, Martin Ollenschleger

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

A number of emerging studies have evaluated clot composition in acute ischemic stroke. Studies of clot composition of embolic strokes of undetermined strokes are lacking.

Objectives

We sought to analyze the RBC to platelet ratios in clots and correlated our findings with stroke etiology.

Methods

This was a prospective study analyzing clots retrieved by mechanical thrombectomy in acute ischemic stroke patients at our institution. All clots were stained and scanned at 200x magnification by using a Scanscope XT digital scanner (Apergio, Vista, California). Image-J software (National Institutes of Health, Bethesda, Maryland) was used for semi quantitative analysis of percentage RBC’s and platelets. Unpaired t-test was used to compare means of RBC to Platelet ratios. Correlation of RBC to Platelet ratios with stroke etiology was performed.

Results

A total of 33 clots from 33 patients were analyzed. Stroke etiology was undetermined in 6 patients, cardioembolic in 14, large vessel atherosclerosis (LVA) in 9, and carotid dissection in 4. The mean RBC to platelet ratio was 0.78:1 (+/− 0.65) in cardioembolic clots, 1.73:1 (+/− 2.38) in LVA and 1.4:1(+/− 0.70) in carotid dissections. Although patients with undetermined etiology had a similar clot composition to cardioembolic stroke (0.36:1+/− 0.33), (p = 0.19), it differed significantly from LVA and dissections respectively (p = 0.037, p = 0.01).

Conclusion

In our study, a low RBC to Platelet ratio was found among patients with embolic strokes of undetermined source, however shared similar characteristics with cardioembolic thrombi. Ongoing collection and analysis is needed to confirm these findings and its significance in evaluating stroke etiology.

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Title: Clot composition of embolic strokes of undetermined source: a feasibility study
Authors: Amre Nouh
Tapan Mehta
Mohamed Hussain
Xianyuan Song
Martin Ollenschleger
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Stroke
Arterial Occlusive Disease
Thrombectomy
Carotid Artery Dissection
Carotid Artery Dissection
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-01969-w

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Clot composition of embolic strokes of undetermined source: a feasibility study

Abstract

Background

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Methods

Results

Conclusion

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