Correlation Study Of Thrombus Composition With Clinical Data And Prognosis In Patients With Acute Ischemic Stroke After Thrombectomy

Objective:The purpose of this study was to investigate the relationship between thrombus composition and clinical data,imaging features,recanalization and prognosis in patients with acute ischemic stroke undergoing thrombectomy.Methods:A total of 44 patients with acute ischemic stroke who underwent intracranial artery thrombectomy in the Department of Neurology,Shaoxing Central Hospital from June 2021 to October 2022 were consecutively enrolled.Hematoxylin-eosin staining and immunohistochemical staining were performed on thrombus specimens.The pathological sections were scanned and analyzed,and the components were semi-quantitatively analyzed,thrombus samples were divided into red blood cell rich type,mixed type and fibrin/platelet rich type.The clinical data,imaging features,vascular recanalization and prognosis at 90 days after onset were collected and analyzed.Results:There were significant differences in the etiology classification among the three groups(P=0.01).Comparing the proportion of thrombus components in different etiological types,it was found that the proportion of red blood cells in large artery atherosclerosis type[58%(44.25,72.5)]was higher than that in cardiogenic embolism type[24.5%(12.75,48)].The proportion of fibrin/platelet was lower in the large atherosclerotic type[40%(25.25,54.5)]than in the cardiac embolic type[73%(49.25,84.5)].There was no significant difference between different thrombus components and cerebral arterial hyperdensity sign(P>0.05).There was no significant difference in the recanalization effect among the three groups(P>0.05).There was no significant difference in the proportion of red blood cells,fibrin/platelet and white blood cells between the good prognosis group and the poor prognosis group(P>0.05),but the number of CD4~+CD25~+regulatory T cells was statistically different between the two groups(P<0.001).Conclusion:The proportion of red blood cells in large artery atherosclerosis thrombus was higher than that in cardiogenic embolism thrombus,and the proportion of fibrin/platelet was lower than that in large artery atherosclerosis thrombus.There was no significant correlation between thrombus composition and cerebral arterial hyperdensity sign or recanalization.A high number of CD4~+CD25~+regulatory T cells in thrombus was associated with a good prognosis,but no significant correlation was found between RBC and fibrin/platelet content and prognosis.