急性期脳梗塞に対する血栓回収療法後の有効再開通と回収した血栓の病理組織学的特徴との関連

• 資料種別: 博士論文
• タイトル: 急性期脳梗塞に対する血栓回収療法後の有効再開通と回収した血栓の病理組織学的特徴との関連
• 著者・編者: 橋本, 哲也
• 著者標目: 橋本, 哲也 ハシモト, テツヤ
• 出版年月日等: 2018-09-30
• 出版年（W3CDTF）: 2018-09-30
• 並列タイトル等: Histopathologic Analysis of Retrieved Thrombi Associated With Successful Reperfusion After Acute Stroke Thrombectomy
• 寄与者: 飯原, 弘二; 北園, 孝成; 飛松, 省三
• 授与機関名: 九州大学
• 授与年月日: 2018-09-30
• 報告番号: 17102乙第08741号
• 学位: 博士（医学）; DOCTOR OF PHILOSOPHY (Medical Science)
• 本文の言語コード: eng
• 対象利用者: 一般
• 記録形式（IMT）: application/pdf
• 著作権情報: やむを得ない事由により本文ファイル非公開 (2); Public access to the fulltext file is restricted for unavoidable reason (2)
• 異版（DOI）: 10.1161/STROKEAHA.116.015228
• 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: 九州大学 : 九州大学学術情報リポジトリ

目次

med2734_abstract.pdf

med2734_review.pdf

BACKGROUND AND PURPOSE：Histopathologic evaluation of occlusive thrombi retrieved from cerebral arteries using endovascular therapy is possible. We investigated the relationship between successful reperfusion after thrombectomy and histopathologic characteristics of retrieved thrombi. / METHODS：Among consecutive patients with acute ischemic stroke treated with endovascular therapy at our institute from December 2010 to July 2015, we retrospectively reviewed those with acute major arterial occlusion from which retrieved thrombi were evaluated histopathologically. Obtained thrombi were assessed for the existence of atheromatous gruel, organization, and the ratios of erythrocyte and fibrin/platelet components. Successful reperfusion was defined as the modified Treatment in Cerebral Ischemia grade of 2b to 3. / RESULTS：Of 83 patients studied, 58 (70%) underwent successful reperfusion. Atheromatous gruel was less frequently identified (3% versus 20%; P=0.024), and the proportion of erythrocyte components was higher (57±23% versus 47±24%; P=0.042) in thrombi retrieved from the reperfused than the unreperfused group. On multivariate logistic regression analysis, atheromatous gruel was inversely related (odds ratio, 0.062; 95% confidence interval, 0.002-0.864), and >64% erythrocyte components (cutoff obtained from receiver operating characteristic curve) were positively related (odds ratio, 4.352; 95% confidence interval, 1.185-19.363) to successful reperfusion. / CONCLUSIONS：Successful reperfusion could be associated with the histopathology of occlusive thrombi, including the existence of atheromatous gruel and proportion of erythrocyte components.