Table 1.
Comparison of clinical and histological findings according to thrombus fragility
| Total (n=310) | Fragile thrombus (n=115) | No fragile thrombus (n=195) | P | |
|---|---|---|---|---|
| Demographics and stroke risk factors | ||||
| Age (yr) | 70.9±13.6 | 70.8±13.7 | 70.9±13.6 | 0.951 |
| Male sex | 153 (49.4) | 57 (49.6) | 96 (49.2) | 0.955 |
| Hypertension | 224 (72.3) | 80 (69.6) | 144 (73.8) | 0.416 |
| Diabetes | 100 (32.3) | 34 (29.6) | 66 (33.8) | 0.436 |
| Dyslipidemia | 81 (26.1) | 24 (20.9) | 57 (29.2) | 0.106 |
| Current smoking | 40 (12.9) | 15 (13.0) | 25 (12.8) | 0.955 |
| Coronary artery occlusive disease | 46 (14.8) | 14 (12.2) | 32 (16.4) | 0.311 |
| Atrial fibrillation | 178 (57.4) | 78 (67.8) | 100 (51.3) | 0.004 |
| Clinical conditions | ||||
| Initial NIHSS score | 14.0 [9.0–18.0] | 15.0 [10.0–18.0] | 12.0 [8.0–18.0] | 0.089 |
| Intravenous tPA administration | 114 (36.8) | 47 (40.9) | 67 (34.4) | 0.251 |
| Location of occlusions | <0.001 | |||
| Internal carotid artery | 84 (27.1) | 47 (40.9) | 37 (19.0) | |
| M1 segment of middle cerebral artery | 120 (38.7) | 41 (35.7) | 79 (40.5) | |
| M2 segment of middle cerebral artery | 75 (24.2) | 21 (18.3) | 54 (27.7) | |
| Anterior cerebral artery | 1 (0.3) | 0 (0.0) | 1 (0.5) | |
| Vertebrobasilar artery | 26 (8.4) | 4 (3.4) | 22 (11.3) | |
| Posterior cerebral artery | 4 (1.3) | 2 (1.7) | 2 (1.0) | |
| Tandem occlusion | 26 (8.4) | 10 (8.7) | 16 (8.2) | 0.880 |
| Onset-to-puncture time (min) | 292.0 [167.0–610.0] | 267.0 [138.0–571.0] | 308.0 [176.0–624.0] | 0.210 |
| Use of balloon guide catheter* | 278 (89.7) | 108 (99.1) | 170 (99.4) | 0.747 |
| Endovascular outcomes | ||||
| Recanalization status† | ||||
| Successful recanalization | 287 (92.6) | 104 (90.4) | 183 (93.8) | 0.268 |
| Complete recanalization | 193 (62.3) | 37 (32.2) | 156 (80.0) | <0.001 |
| First-pass effect | 102 (32.9) | 5 (4.4) | 97 (49.7) | <0.001 |
| Number of passes of stent retriever | 2.3±1.4 | 2.8±1.3 | 2.0±1.4 | <0.001 |
| Puncture-to-recanalization time (min) | 31.0 [20.0–49.5] | 33.5 [24.0–53.0] | 29.0 [19.0–49.0] | 0.128 |
| Thrombus composition (%) | ||||
| Erythrocyte | 35.6 [20.3–46.7] | 40.2 [30.7–51.4] | 31.0 [16.6–43.3] | <0.001 |
| Platelet | 9.7 [4.3–19.5] | 8.9 [3.8–17.4] | 10.9 [4.5–20.7] | 0.057 |
| Fibrin | 32.3 [21.2–47.2] | 31.6 [21.0–48.1] | 32.7 [21.4–45.7] | 0.875 |
| Leukocytes | 8.5 [4.2–15.7] | |||
| Lymphocyte | 0.3 [0.2–0.5] | 0.3 [0.2–0.5] | 0.2 [0.1–0.4] | 0.135 |
| Neutrophil | 0.6 [0.2–2.1] | 0.7 [0.2–2.5] | 0.6 [0.2–2.0] | 0.813 |
| Monocyte | 5.0 [2.2–11.1] | 5.1 [2.3–10.7] | 4.9 [2.1–11.6] | 0.989 |
| Tissue factor | 12.8 [1.5–42.7] | 13.9 [1.9–45.1] | 11.8 [1.1–41.0] | 0.608 |
| Neutrophil extracellular trap | 2.7 [1.1–5.1] | 3.0 [1.1–6.4] | 2.7 [1.1–4.6] | 0.368 |
Values represent mean±standard deviation, number (%), or median [interquartile range].
NIHSS, National Institutes of Health Stroke Scale; tPA, tissue-type plasminogen activator.
*
The calculation of the percentages of patients using a balloon-guided catheter was limited to those with anterior circulation stroke;
†
Successful recanalization was defined as achieving final modified Thrombolysis In Cerebral Infarction (mTICI) 2b or 3; Complete recanalization was defined as the attainment of a final mTICI score of 3.