Table 1.
Patient with large vessel occlusion (LVO) syndromes.
| Characteristics of patients with LVO | ||||||||
| Patient ID | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
| Demographics and vascular history | ||||||||
| Age | 67 | 69 | 40 | 46 | 27 | 55 | 55 | 73 |
| Sex | Male | Male | Male | Male | Male | Male | Male | Male |
| Race | South Asian | Caucasian | African American | African American | South Asian | South Asian | African American | African American |
| Vascular risk factors | DM, HTN | HTN, Smoking | DM, HTN | None | None | DM, HTN, Smoking | DM | HTN, CVA |
| COVID history | ||||||||
| COVID symptoms | Fever, Dyspnea | Fever, Cough, Dyspnea | None | Shock, Hypoxia | Fever, Cough | Fever, Cough, Chills, Dyspnea | None | None |
| COVID Treatment | HCQ*, AZT; Doxycycline | HCQ, Doxycycline | AZT,HCQ* | HCQ, AZT | N/A | Ceftriaxone, AZT | HCQ, AZT | None |
| Other Systemic Disease | AKI, NSTEMI | AKI | N/A | N/A | N/A | N/A | N/A | AKI |
| Stroke history and acute imaging | ||||||||
| LKW-symptom detection (mins) | 780 | 360 | 0 | 1,320 | 30 | 240 | 1,320 | 540 |
| Symptoms detection -Door (mins) | 0 | 40 | 905 | 66 | 97 | 0 | 200 | 200 |
| NIHSS (admission) | 21 | 21 | 26 | 32 | 18 | 23 | 25 | 6 |
| CT ASPECTS | 4 | 5 | 7 | N/A | 9 | 4 | 4 | 7 |
| CTA/MRA lesion | Left ICA | Left M1/MCA | Left M1/MCA | Proximal Basilar | Left M1/MCA | Right ICA-T | Left ICA+MCA | Left ICA non occlusive mural thrombus without atherosclerosis f/b complete ICA-MCA occlusion |
| Stroke therapy and prophylaxis | ||||||||
| EVT | N | N | Y | N | Y | N | N | N |
| No EVT reason | Low ASPECTS | Low ASPECTS | N/A | Medically Unstable | N/A | Low ASPECTS | Low ASPECTS | Rapid infarct progression |
| IV tPA | N | N | N | N | Y | N | N | N |
| TICI | N/A | N/A | 2b | N/A | 2b | N/A | N/A | N/A |
| Stroke prophylaxis agent | Clopidogrel | UFH | ASA f/b DOAC | UFH | DAPT f/b LMWH | UFH | ASA | Eptifibatide f/b DAPT |
| Imaging (non-acute) | ||||||||
| CXR | B/L patchy infiltrates | interstitial opacities bilateral | Left lower field hazy opacity | B/L atelectasis | B/L patchy infiltrates | B/L patchy opacities | B/L ground glass opacities | B/L upper ground glass opacities |
| Ejection fraction | N/A | 60% | 26% | 60% | 75% | 60% | 60% | N/A |
| Other echo abnormalities | N/A | Mild Left Atrial dilatation | global LV hypokinesis | N/A | N/A | N/A | N/A | None |
| MRI brain (Follow-up infarcts) | N/A | Left MCA partial (deep + parietal) | Left Basal Ganglia, temporal gyri, frontal | N/A | N/A | N/A | N/A | Complete infarction of Left MCA territory |
| CT head (Follow-up) | B/L MCA territories' infarction | Left MCA deep | N/A | Right pontine/left cerebellar stroke | N/A | Right hemispheric infarction and Occipital ICH | Left hemispheric infarction | Mild early changes in left parieto-occipital areas |
| Outcome and etiology | ||||||||
| Etiology | Cardio: Prob | Undetermined: Crypto | Cardio: Poss | Undetermined: Crypto | Undetermined: Crypto | Undetermined: Crypto | Undetermined: Crypto | Undetermined: Unclassified* |
| mRS at discharge | 6 | 4 | 3 | 6 | 3 | 6 | 6 | 6 |
LVO, Large Vessel Occlusion; DM, diabetes mellitus; HTN, hypertension; CVA, cerebrovascular accident; Y, Yes; N, No; HCQ, hydroxychloroquine; AZT, azathioprine; AKI, Acute Kidney Injury; NSTEMI, Non ST Elevation Myocardial Infarction; N/A, Not Applicable/Available; LKW, last known well; mins, minutes; NIHSS, National Institutes of Health Stroke Score; CT, computed tomography; ASPECTS, Alberta Stroke Program Early CT Score; CTA, CT Angiography; MRA, Magnetic Resonance Angiography; ICA, internal carotid artery; MCA, middle cerebral artery; M1, M1 segment of Middle Cerebral Artery; ICA-T, ICA Terminus; f/b, followed by; EVT, endovascular therapy; tPA, tissue plasminogen activator; TICI, thrombolysis in cerebral infarction; AP, antiplatelet; AC, anticoagulation; UFH, unfractionated heparin; ASA, acetylsalicylic acid; DOAC, Direct Oral Anticoagulants; DAPT, Dual Anti-platelet Agents; LMWH, low molecular weight heparin; NLR, neutrophil-lymphocyte ratio; WBC, white blood cell count; INR, international normalized ratio; PTT, partial thromboplastin time; CRP, c-reactive protein; LDH, lactate dehydrogenase; CPK, creatine phosphokinase; LDL, low-density lipoprotein; CXR, chest x-ray; B/L, Bilateral; LV, Left Ventricle; ICH, intracranial hemorrhage; Prob, Probable; Poss, Possible; Crypto, Cryptogenic; mRS, modified Rankin scale.
Patient considered to have mural thrombus of unknown etiology (no dissection flaps or underlying atherosclerotic plaque visualized on angiographic modality) with possible progression to further thrombosis and/or embolization of the entire vascular tree.