London, United Kingdom 2013 E-Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 255 15 Translational stroke research Immunohistochemical study of clot composition in thrombi retrieved from MCA with mechan-ical thrombectomy E. López-Cancio1, M. Millán2, N. Pérez de la Ossa3, A. Dávalos4, M. Ribó5, A. Morancho6, M. Hernández-Guillamon7, C. Boada8, A. Penalba9, J. Montaner10 Department of Neurosciences, Stroke Unit, Germans Trias i Pujol University Hospital, Badalo-na, SPAIN1, Department of Neurosciences, Stroke Unit, Germans Trias i Pujol University Hospital, Badalona, SPAIN2, Department of Neurosciences, Stroke Unit, Germans Trias i Pujol University Hospital, Badalona, SPAIN3, Department of Neurosciences, Stroke Unit, Germans Trias i Pujol Uni-versity Hospital, Badalona, SPAIN4, Neurovascular Research Laboratory, Vall d’Hebron University Hospital Research Institute, Barcelona, SPAIN5, Neurovascular Research Laboratory, Vall d’Hebron University Hospital Research Institute, Barcelona, SPAIN6, Neurovascular Research Laboratory, Vall d’Hebron University Hospital Research Institute, Barcelona, SPAIN7, Neurovascular Research Laboratory, Vall d’Hebron University Hospital Research Institute, Barcelona, SPAIN8, Neurovascu-lar Research Laboratory, Vall d’Hebron University Hospital Research Institute, Barcelona, SPAIN9, Neurovascular Research Laboratory, Vall d’Hebron University Hospital Research Institute, Barcelo-na, SPAIN10 BACKGROUND: In the era of new endovascular therapies (EVT) with stent-retrievers, we have now easy access to study intracerebral thrombi composition. Few previous studies focused on histo-pathology and ultraestructure of thrombi. Our aim was to determine for the first time thrombi bio-markers associated with the hyperdense MCA sign (HMCAS) as a surrogate of clot composition and predictor of successful recanalization, and with other clinical and procedure variables. METHODS: We analyzed arterial thrombi retrieved from acute MCA occlusions, using Solitaire device. Fresh thrombi were immediately stored at -80ºC until analyzed. We immunohistochemical-ly evaluated the presence of Fibrinogen, PAI-1, P-selectin and Von Willebrand factor (VWf) in the retrieved thrombi by fluorescence microscopy. We quantified each biomarker separately and stud-ied its association with the presence of HMCAS in baseline CT, time of brain ischemia, duration of endovascular procedure, number of passes of thrombectomy, final TICI score, stroke etiology and reperfusion treatments received. RESULTS: We studied 15 patients (11 M;mean age 70 years) with a MCA occlusion (9 cardioem-bolic and 6 atherothrombotic). Fibrinogen content was significantly higher in patients that showed a HMCAS compared to those without (p=0.029,fig 1). Biomarker content was not significantly dif-ferent depending on time of brain ischemia, duration of endovascular procedure, number of passes of thrombectomy, final TICI or stroke etiology. VWf and PAI-1 content were significantly higher in thrombi retrieved after intravenous rtPA use, compared to thrombi retrieved in primary EVT (p=0.014). CONLUSION: A HMCAS in an acute MCA occlusion may reflect a higher content in fibrinogen within the occluding clot. We found higher content of VWf and PAI-1 in thrombi retrieved after non-successful intravenous thrombolysis. Both facts point to molecular clot variability and open the possibility of personalizing endovascular therapies.
Karger_ESC London_2013
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