Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review.
BACKGROUND AND PURPOSE: Studying the imaging and histopathologic characteristics of thrombi in ischemic stroke could provide insights into stroke etiology and ideal treatment strategies. We conducted a systematic review of imaging and histologic characteristics of thrombi in acute ischemic stroke.
MATERIALS AND METHODS: We identified all studies published between January 2005 and December 2015 that reported findings related to histologic and/or imaging characteristics of thrombi in acute ischemic stroke secondary to large vessel occlusion. The five outcomes examined in this study were (1) association between histologic composition of thrombi and stroke etiology; (2) association between histologic composition of thrombi and angiographic outcomes; (3) association between thrombi imaging and histologic characteristics; (4) association between thrombi imaging characteristics and angiographic outcomes; and (5) association between imaging characteristics of thrombi and stroke etiology. A meta-analysis was performed using a random effects model.
RESULTS: There was no significant difference in the proportion of red blood cell (RBC)-rich thrombi between cardioembolic and large artery atherosclerosis etiologies (OR 1.62, 95% CI 0.1 to 28.0, p=0.63). Patients with a hyperdense artery sign had a higher odds of having RBC-rich thrombi than those without a hyperdense artery sign (OR 9.0, 95% CI 2.6 to 31.2, p
CONCLUSIONS: The hyperdense artery sign is associated with RBC-rich thrombi and improved recanalization rates. However, there was no association between the histopathological characteristics of thrombi and stroke etiology and angiographic outcomes.
Published In/Presented At
Brinjikji, W., Duffy, S., Burrows, A., Hacke, W., Liebeskind, D., Majoie, C. B. L. M., Dippel, D. W. J., Siddiqui, A. H., Khatri, P., Baxter, B., Nogeuira, R., Gounis, M., Jovin, T., & Kallmes, D. F. (2017). Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review. Journal of neurointerventional surgery, 9(6), 529–534. https://doi.org/10.1136/neurintsurg-2016-012391
Diagnosis | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Radiology
Department of Radiology and Diagnostic Medical Imaging