Associations between thrombus characteristics on computed tomography and endovascular treatment effect in acute ischemic stroke patients

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Abstract

Objective: The aim of this study is to evaluate associations between Clot Burden Score, clot perviousness on computed tomography and endovascular treatment effect in patients presenting with anterior circulation large artery occlusion who underwent endovascular mechanical thrombectomy.

Methods: We retrospectively examined 92 patients with acute ischemic stroke undergoing computed tomography angiography, perfusion MR and endovascular mechanical thrombectomy.

Results: 70 (76,1%) had high CBS and 22 had low CBS. In the high CBS group, infarct volume and Tmax > 6 seconds volume were less than in the low CBS group. The high CBS group showed a strong trend toward lower procedure time (52 minutes versus 1 hour 24 minutes, p < 0,01). Number of Stent Retriever passes in the high CBS group was smaller than the other. Only 5,71% of the patients with high CBS ratios failed reperfusion, whereas 94,28% of those patients underwent successful reperfusion. Converly, 22,72% of the patients with low CBS had failed reperfusion. Patients with a high CBS group had smaller final infarct volume (18ml versus 89,5ml, p < 0,001) and smaller growth infarct volume (8ml versus 52,5ml, p < 0,001). There was no correlation between CBS and hemorrhagic transformation or symptomatic intracranial hemorrhage after endovascular therapy. Final infarct volume was moderately negatively correlated with clot perviousness p = -0,234, KTC 95% (-0,438) - (-0,008), p < 0,05.

Conclusion: The CBS scoring system provides an easy and rapid estimation of thrombus burden in stroke patients. Clot Burden Score can be used as a marker to stratify patients and predict outcome after endovascular thrombectomy in patients with a window extending to 24 hours.

https://doi.org/10.38103/jcmhch.90.19

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Published 29-12-2024
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Issue No. 90 (2023)
Section Original article
DOI 10.38103/jcmhch.90.19
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Copyright (c) 2023 Journal of Clinical Medicine Hue Central Hospital

Phan Thi Kim Lien, Nguyen Duc Khang, Tran Quang Hien, & Huynh Quang Huy. (2024). Associations between thrombus characteristics on computed tomography and endovascular treatment effect in acute ischemic stroke patients. Journal of Clinical Medicine Hue Central Hospital, (90), 121–127. https://doi.org/10.38103/jcmhch.90.19