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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >CT-based Higher Thrombus Density is associated with Secondary Embolism during Mechanical Thrombectomy: A Preliminary Observation
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CT-based Higher Thrombus Density is associated with Secondary Embolism during Mechanical Thrombectomy: A Preliminary Observation

机译：基于CT的血栓密度与机械血栓切除术期间的二级栓塞有关：初步观察

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Background: Secondary embolism (SE) during mechanical thrombectomy (MT) for acute ischemic stroke (AIS) is the main reason for incomplete recanalization, while its risk factors are largely unknown. This study addresses a potential relationship between thrombus density on preinterventional computed tomography (CT) and the occurrence of SE. Methods: We reviewed anterior circulation AIS patients who underwent MT from July 2015 to January 2019 in our center. Thrombus density was measured in Hounsfield Units (HU) on 1-mm and 5-mm preinterventional nonenhanced CT (NECT). Thrombus density, baseline characteristics, procedural, and clinical outcomes were compared between patients with SE and those without SE. Logistic regression was conducted to identified potential risk factors of SE. Results: Sixty-four consecutively patients were included, of whom SE was identified in 16 (25.0%) patients. Compared with those without SE, patients with SE showed a higher thrombus density on both 1-mm (72.85 versus 64.28, P = .005) and 5-mm NECT (60.31 versus 49.71, P < .001), a higher proportion of atrial fibrillation (75.0% versus 45.8%, P = .043), a lower clot burden score (.5 versus 6.0, P = .029), and a higher proportion of front-line contact aspiration strategy (50.0% versus 16.7%, P = .020). Multivariate regression analysis showed that only thrombus density was the independent predictor of SE (for the model including HU values on 1-mm NECT, OR 1.11, 95%CI 1.01-1.23, P = .029; for the model including HU values on 5-mm NECT, OR 1.09, 95%CI 1.02-1.17, P = .018). Conclusions: Higher thrombus density was the independent predictor for SE. Further studies are needed to investigate its role in the optimization of thrombectomy strategy.
机译：背景：急性缺血性卒中（AIS）机械血液切除术（MT）期间的二级栓塞（SE）是不完全重组的主要原因，而其风险因素在很大程度上是未知的。本研究解决了血栓密度对初步计算机断层扫描（CT）的潜在关系和SE的发生。方法：我们审查了从2015年7月至2019年1月在我们的中心接受了MT的前循环AIS患者。在1毫米和5mm的预穿透非抗性CT（Nect）上以Hounsfield单元（Hu）测量血栓密度。血栓密度，基线特征，程序和临床结果进行了比较患者和没有SE的患者。进行了逻辑回归以确定SE的潜在风险因素。结果：包括六十四所患者，其中患有16名（25.0％）患者的硒。与那些没有SE的患者相比，硒患者在1毫米（72.85与64.28，P = .005）和5毫米NECT上显示出更高的血栓密度（72.85与64.28，p = .31，p <.001，p <.001），高比例的心房纤维化（75.0％对45.8％，p = .043），较低的凝块负荷得分（.5与6.0，p = .029），较高比例的前线接触展示策略（50.0％与16.7％，p = .020）。多元回归分析表明，只有血栓密度是SE的独立预测因子（对于在1毫米Nect的HU值，或1.11,95％CI 1.01-1.23，P = .029中的模型;对于包括HU值的模型-mm nect，或1.09,95％ci 1.02-1.17，p = .018）。结论：血栓密度较高是SE的独立预测因子。需要进一步研究来探讨其在血栓切除术策略的优化中的作用。

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