RT Journal Article
SR Electronic
T1 Platelet-rich emboli are associated with von Willebrand factor levels and have poorer revascularization outcomes
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 557
OP 562
DO 10.1136/neurintsurg-2019-015410
VO 12
IS 6
A1 Douglas, Andrew
A1 Fitzgerald, Seán
A1 Mereuta, Oana Madalina
A1 Rossi, Rosanna
A1 O'Leary, Sean
A1 Pandit, Abhay
A1 McCarthy, Ray
A1 Gilvarry, Michael
A1 Holmegaard, Lukas
A1 Abrahamsson, Margareta
A1 Jerndal, Mikael
A1 Dehlfors, Niclas
A1 Brennan, Paul
A1 Power, Sarah
A1 O'Hare, Alan
A1 Griffin, Emma
A1 Kallmes, David F
A1 Brinjikji, Waleed
A1 Szikora, István
A1 Tatlisumak, Turgut
A1 Rentzos, Alexandros
A1 Thornton, John
A1 Doyle, Karen
YR 2020
UL http://jnis.bmj.com/content/12/6/557.abstract
AB Background and aims Platelets and von Willebrand factor (vWF) are key factors in thrombosis and thus are likely key components of acute ischemic stroke (AIS) emboli. We aimed to characterize platelet and vWF levels in AIS emboli and to assess associations between their expression levels and clinical and procedural information.Materials and method Histopathological and immunohistochemical analysis of emboli collected as part of the multi-institutional RESTORE registry was performed. The composition of the emboli was quantified using Orbit Image Analysis machine learning software. Correlations between clot components and clinical and procedural information were assessed using the χ2 test.Results Ninety-one emboli samples retrieved from 63 patients were analyzed in the study. The mean platelet (CD42b) content of the clots was 33.9% and the mean vWF content of the clots was 29.8%. There was a positive correlation between platelet and vWF levels (ρ=0.564, p<0.001*, n=91). There was an inverse correlation between both platelets and vWF levels and percentage of red blood cells (RBCs) in the emboli (CD42b vs RBC: ρ=−0.535, p<0.001*, n=91; vWF vs RBC: ρ=−0.366, p<0.001*, n=91). Eighty-one percent of patients in the low platelet group had a good revascularization outcome (Thrombolysis in Cerebral Infarction 2c/3) compared with 58% in the high platelet group (χ2=5.856, p=0.016).Conclusion Platelet and vWF levels in AIS emboli correlate with each other and both have an inverse relationship with RBC composition. Patients with platelet-rich clots have poorer revascularization outcomes.