Introduction
Materials and methods
Setting and patients
Histological thrombus composition
Thrombus computed tomography characteristics
Statistical analysis
Results
≤ 19.8% RBCs (n = 111) | 19.9–36.7% RBCs (n = 111) | > 36.8% RBCs (n = 110) | Total (n = 332) | |
---|---|---|---|---|
Age, year, median (IQR) | 71 (58–80) | 70 (63–79) | 70 (59–76) | 70 (60–79) |
Men, n (%) | 50 (45) | 61 (55) | 66 (60) | 177 (53) |
NIHSS, median (IQR) | 17 (11–20) | 18 (13–20) | 17 (14–21) | 17 (13–20) |
Systolic blood pressure, mmHg, mean (SD) | 147 (23) | 149 (24) | 151 (26) | 149 (24) |
Intravenous alteplase treatment, n (%) | 85 (77) | 85 (77) | 81 (74) | 251 (76) |
Hyperdense artery sign, n (%) | 48 (46) | 63 (60) | 78 (73) | 189 (60) |
Clot burden score, median (IQR) | 6 (4–8) | 6 (4–7) | 5 (2–6) | 6 (4–7) |
Medical history | ||||
Diabetes mellitus, n (%) | 20 (18) | 23 (21) | 14 (13) | 57 (17) |
Hypertension, n (%) | 58 (54) | 61 (56) | 59 (54) | 178 (55) |
Atrial fibrillation, n (%) | 34 (31) | 31 (28) | 27 (25) | 92 (28) |
Ischemic stroke, n (%) | 23 (21) | 26 (24) | 17 (16) | 66 (20) |
Peripheral artery disease, n (%) | 17 (16) | 9 (8) | 17 (16) | 43 (13) |
Current smoking, n (%) | 35 (32) | 26 (23) | 26 (24) | 74 (22) |
Collateral grade | ||||
0, n (%) | 3 (3) | 10 (10) | 14 (14) | 27 (9) |
1, n (%) | 40 (39) | 36 (36) | 33 (32) | 109 (36) |
2, n (%) | 35 (34) | 42 (42) | 36 (35) | 113 (37) |
3, n (%) | 26 (25) | 13 (13) | 19 (19) | 38 (19) |
Occlusion location subgroups | ||||
Intracranial ICA, n (%) | 2 (2) | 4 (4) | 6 (6) | 12 (4) |
ICA-terminus, n (%) | 19 (18) | 27 (26) | 44 (41) | 90 (28) |
Proximal M1, n (%) | 34 (32) | 29 (28) | 36 (34) | 99 (31) |
Distal M1, n (%) | 39 (36) | 34 (33) | 18 (17) | 91 (29) |
M2, n (%) | 13 (12) | 9 (9) | 3 (3) | 25 (8) |
A1/A2, n (%) | 1 (1) | 0 (0) | 0 (0) | 1 (0) |
Workflow | ||||
Time from stroke onset to CT, min, median (IQR) | 72 (60–110) | 65 (50–113) | 69 (53–115) | 69 (53–114) |
Time from stroke onset to groin puncture, min, median (IQR) | 200 (155–260) | 205 (155–266) | 209 (166–260) | 205 (160–260) |
Association of thrombus CT characteristics with thrombus composition
Unadjusted | Adjusted for clinical characteristics* | Adjusted for thrombus CT characteristics† | |
---|---|---|---|
Hyperdense artery sign | 9.8 (5.8 to 13.7) | 9.8 (5.8 to 13.7) | 7.8 (3.9 to 11.7) |
Occlusion location | − 5.5 (− 7.5 to − 3.5) | − 5.5 (− 7.6 to -3.5) | − 3.9 (− 7.1 to − 0.6) |
Clot burden score | − 1.9 (− 2.7 to − 1.1) | − 1.9 (− 2.7 to − 1.1) | − 0.4 (− 1.7 to 0.9) |
Unadjusted | Adjusted for clinical characteristics* | Adjusted for thrombus CT characteristics† | |
---|---|---|---|
Hyperdense artery sign | 5.5 (− 2.4 to 13.3) | 5.7 (− 2.1 to 13.5) | − 3.7 (− 11.7 to 4.2) |
Occlusion location | − 4.4 (− 8.4 to − 0.4) | − 4.0 (− 8.1 to 0.1) | − 4.1 (− 13.5 to 5.4) |
Clot burden score | − 1.7 (− 3.3 to − 0.1) | − 1.4 (− 3.0 to 0.2) | 1.0 (− 2.2 to 4.1) |
Absolute thrombus density (HU) | 0.9 (0.5 to 1.3) | 0.8 (0.5 to 1.2) | 0.8 (0.3 to 1.4) |
Thrombus length (mm) | 0.9 (0.5 to 1.3) | 0.8 (0.4 to 1.3) | 0.8 (0.2 to 1.4) |
Relative thrombus density (HU) | 13.1 (− 0.8 to 27.1) | 14.2 (0.4 to 28.0) | − 10.4 (− 26.8 to 6.1) |
Perviousness (HU) | − 0.4 (− 0.6 to − 0.1) | − 0.4 (− 0.6 to − 0.1) | − 0.2 (− 0.4 to 0.0) |
DT (mm) | − 0.6 (− 1.1 to − 0.0) | − 0.5 (− 1.0 to 0.1) | 0.6 (− 0.3 to 1.5) |