Age and composition of the thrombus retrieved by mechanical thrombectomy from patients with acute ischemic stroke are associated with revascularization and clinical outcomes.

• 資料種別: 博士論文
• タイトル: Age and composition of the thrombus retrieved by mechanical thrombectomy from patients with acute ischemic stroke are associated with revascularization and clinical outcomes.
• 著者・編者: Shimizu, Hisao; Hatakeyama, Kinta; Saito, Kozue; Shobatake, Ryogo; Takahashi, Nobuyuki; Deguchi, Jun; Tokunaga, Hidemori; Shimada, Keiji; Nakagawa, Ichiro; Myochin, Kaoru; Sakai, Kazuya; Kubo, Masayuki; Yamashita, Atsushi; Obayashi, Chiho; Sugie, Kazuma; Matsumoto, Masanori
• 著者標目: Shimizu, Hisao; Hatakeyama, Kinta; Saito, Kozue; Shobatake, Ryogo; Takahashi, Nobuyuki; Deguchi, Jun; Tokunaga, Hidemori; Shimada, Keiji; Nakagawa, Ichiro; Myochin, Kaoru; Sakai, Kazuya; Kubo, Masayuki; Yamashita, Atsushi; Obayashi, Chiho; Sugie, Kazuma; Matsumoto, Masanori
• 出版事項: Elsevier
• 出版年月日等: 2022-11
• 出版年（W3CDTF）: 2022-11
• 並列タイトル等: 急性期虚血性脳卒中患者から機械的血栓回収術で得られた血栓の年齢と組成は血栓回収術転帰および臨床転帰と関連していた
• タイトル（掲載誌）: Thrombosis research
• 巻号年月日等（掲載誌）: 219
• 掲載巻: 219
• 掲載ページ: 60-69
• ISSN（掲載誌）: ISSN : 0049-3848
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2022-12-22
• 報告番号: 甲第855号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: Thrombus age; Mechanical thrombectomy; Acute ischemic stroke; Revascularization
• 対象利用者: 一般
• 一般注記: type:Thesis; Introduction: Understanding the composition of stroke thrombi retrieved by mechanical thrombectomy is essential to clarify the pathogenesis of stroke. However, it is difficult to evaluate thrombus composition precisely and objectively. Immunohistochemical staining was used to evaluate thrombus composition and age. Materials and methods: Consecutive thrombi (n = 108) retrieved from patients who underwent mechanical thrombectomy for acute large-vessel ischemic stroke were retrospectively analyzed. Lytic features of granulocytes and CD163 were estimated as indicators of the age of the cardioembolic (CE) thrombus. Results: The stroke subtypes were as follows: CE, 74 cases; large artery atherosclerosis, 11; undetermined etiology, 12; and other determined etiology, 11. There were no statistical differences in thrombi composition according to stroke subtypes. The fibrin area was positively correlated with the red blood cell (RBC) and platelet areas. The following analysis was performed using CE only. Regarding age, the thrombus was judged as fresh in 30.0 % and older in 70.0 % based on the lytic features. The RBC areas of older thrombi were smaller than those of fresh thrombi. The puncture-to-reperfusion time of older thrombi was longer than that of fresh thrombi. Platelet-rich thrombi were associated with a greater number of maneuvers, a smaller prevalence of TICI 3, and unfavorable functional outcomes compared to platelet-poor thrombi. The number of CD163 positive cells in thrombi with anticoagulants was higher than in those without anticoagulants. Conclusion: Thrombus composition correlated with revascularization and clinical outcomes. The composition of an acute ischemic thrombus may reflect the pathophysiology of stroke and influence treatment efficacy.; 博士（医学）・甲第855号・令和4年12月22日; Copyright © 2022 Elsevier Ltd. All rights reserved.; identifier:Thrombosis research Vol.219 p.60-69 (2022 Nov); identifier:00493848; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4084; identifier:Thrombosis research, 219: 60-69
• オンライン閲覧公開範囲: インターネット公開
• 関連情報（DOI）: 10.1016/j.thromres.2022.09.004
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

目次

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4084/1/01%e7%94%b2855%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4084/2/02%e7%94%b2855%e5%af%a9%e6%9f%bb%e8%a6%81%e6%97%a8.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4084/3/03%e7%94%b2855%e6%9c%ac%e6%96%87.pdf fulltext

http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/4084/4/04%e7%94%b2855Suppl..pdf fulltext