PDF(Pubmed)
Abstract：
BACKGROUND: Acute embolic ischemic stroke poses a significant healthcare challenge. Histological clot features\' variability among patients with acute ischemic stroke treated by mechanical thrombectomy has potential implications for determining treatment and etiology. This study investigated the clot histological feature differences among patients who experienced cardioembolic stroke and embolic stroke of undetermined source with different left atrial appendage (LAA) morphologies.
METHODS: We conducted a prospective observational study involving 79 patients with acute embolic ischemic stroke undergoing mechanical thrombectomy. Computed tomography angiography images were used to classify LAA morphologies. An artificial intelligence algorithm assessed the clot fibrin and red blood cell contents.
RESULTS: Patients with chicken-wing LAA morphology exhibited lower mean clot fibrin proportions than did those with non-chicken-wing morphology (p < 0.001). Linear regression analysis showed that chicken-wing LAA was significantly associated with a lower clot fibrin proportion (estimate, -0.177; 95% CI [-0.259, -0.096]; p < 0.001). The successful recanalization rate and first-pass effect between the groups did not differ significantly.
CONCLUSIONS: The chicken-wing LAA morphological type is associated with lower clot fibrin contents, suggesting potentially different embolism mechanisms or diverse embolic sources, compared with the non-chicken-wing LAA types. Further studies are required to investigate this association.
METHODS: We conducted a prospective observational study involving 79 patients with acute embolic ischemic stroke undergoing mechanical thrombectomy. Computed tomography angiography images were used to classify LAA morphologies. An artificial intelligence algorithm assessed the clot fibrin and red blood cell contents.
RESULTS: Patients with chicken-wing LAA morphology exhibited lower mean clot fibrin proportions than did those with non-chicken-wing morphology (p < 0.001). Linear regression analysis showed that chicken-wing LAA was significantly associated with a lower clot fibrin proportion (estimate, -0.177; 95% CI [-0.259, -0.096]; p < 0.001). The successful recanalization rate and first-pass effect between the groups did not differ significantly.
CONCLUSIONS: The chicken-wing LAA morphological type is associated with lower clot fibrin contents, suggesting potentially different embolism mechanisms or diverse embolic sources, compared with the non-chicken-wing LAA types. Further studies are required to investigate this association.
摘要：
背景：急性栓塞性缺血性卒中构成了重大的医疗挑战。经机械取栓治疗的急性缺血性卒中患者的组织学凝块特征的变异性对确定治疗和病因具有潜在意义。这项研究调查了患有心源性栓塞性中风和不明来源且左心耳（LAA）形态不同的栓塞性中风患者的凝块组织学特征差异。
方法：我们进行了一项前瞻性观察性研究，纳入79例急性栓塞性缺血性卒中患者，接受机械取栓。使用计算机断层扫描血管造影图像对LAA形态进行分类。人工智能算法评估血凝块纤维蛋白和红细胞含量。
结果：具有鸡翅LAA形态的患者比非鸡翅形态的患者显示出更低的平均血凝块纤维蛋白比例（p<0.001）。线性回归分析表明，鸡翅LAA与较低的血凝块纤维蛋白比例显着相关（估计，-0.177；95%CI[-0.259，-0.096]；p<0.001）。两组之间的成功再通率和首过效应没有显着差异。
结论：鸡翅左心耳形态类型与较低的血凝块纤维蛋白含量有关，提示潜在不同的栓塞机制或不同的栓塞来源，与非鸡翅左心耳类型相比。需要进一步的研究来调查这种关联。
方法：我们进行了一项前瞻性观察性研究，纳入79例急性栓塞性缺血性卒中患者，接受机械取栓。使用计算机断层扫描血管造影图像对LAA形态进行分类。人工智能算法评估血凝块纤维蛋白和红细胞含量。
结果：具有鸡翅LAA形态的患者比非鸡翅形态的患者显示出更低的平均血凝块纤维蛋白比例（p<0.001）。线性回归分析表明，鸡翅LAA与较低的血凝块纤维蛋白比例显着相关（估计，-0.177；95%CI[-0.259，-0.096]；p<0.001）。两组之间的成功再通率和首过效应没有显着差异。
结论：鸡翅左心耳形态类型与较低的血凝块纤维蛋白含量有关，提示潜在不同的栓塞机制或不同的栓塞来源，与非鸡翅左心耳类型相比。需要进一步的研究来调查这种关联。
