Pathological Analysis Of Thrombus After Interventional Thrombectomy In 80 Patients With Ischemic Stroke

Objective: In this study,through the pathological analysis of thrombus in patients with ischemic stroke,the relationship between the histological components of thrombus was explored,and the relationship between thrombus pathology and the etiology,imaging,operative time,recanalization effect and prognosis of ischemic stroke was discussed.Methods: Patients with ischemic stroke who were admitted to Department of Neurology,Chenzhou First People’s Hospital from January2020 to December 2020 and needed mechanical thrombolectomy for 24 h of great vessel occlusion were selected.Demographic information,risk factors for cerebrovascular disease,NIHSS score,ASPECT score,operative time,recanalization,laboratory test results and imaging data during hospitalization,thrombopathology data,and MRS score 3 months after onset were collected.The relationship between thrombus pathology and imaging was analyzed.The relationship between thrombus pathology and operation time and recanalization effect;The relationship between the etiology of AIS in thrombosis pathology;Relationship between thrombus pathology and prognosis.Results:1.There were no statistically significant differences in age,gender,smoking history,history of diabetes mellitus,history of hyperlipidemia,past stroke history,family stroke history,NIHSS score and Aspects score among patients with red thrombosis,white thrombosis and mixed thrombosis.The history of hypertension in the red thrombosis group was higher than that in the other two groups.The history of atrial fibrillation in the white thrombosis group was higher than that in the other two groups,and the difference was statistically significant.2.The proportion of red blood cells in the thrombus with HMCAS was higher than that in the thrombus without HMCAS.3.The operative time of red thrombus was lower than that of white thrombus and mixed thrombus;Those with a higher percentage of red blood cells had better recanalization.4.The number of CD3 positive cells in atherosclerotic thrombus was higher than that in cardiogenic embolism and cryptogenic stroke,and the number of CD68 positive cells in atherosclerotic thrombus was lower than that in cardiogenic embolism and cryptogenic stroke,with statistical significance.There was no significant difference between CD3 and CD68 positive cells in cardiogenic embolic thrombosis and cryptogenic stroke.5.The proportion of red blood cell components in atherosclerotic thrombus was higher than that in cardiogenic embolism and cryptogenic stroke,while the proportion of fibrin/platelet components and white blood cell components in atherosclerotic thrombus was lower than that in cardiogenic embolism and cryptogenic stroke,and the difference was statistically significant.There was no statistically significant difference in the proportion of thrombus components between cryptic stroke and cardiogenic embolism.Atherosclerotic thrombosis was mainly red thrombosis,while cardiogenic embolism and cryptogenic stroke thrombosis were white thrombosis and mixed thrombosis,and the difference was statistically significant.6.There was no statistically significant difference in prognosis between red thrombosis,white thrombosis and mixed thrombosis.Conclusion:1.Atherosclerotic thrombosis has a higher ratio of red blood cells and a lower ratio of fibrin to platelets and white blood cells compared with cardiogenic embolism and cryptogenic stroke.The thrombohistological composition of cardiac embolism is similar to that of cryptogenic stroke.2.Red thrombosis is the most common type of aortic thrombosis,while white thrombosis and mixed thrombosis are common in cardiogenic embolism and cryptogenic stroke.The operation time of red thrombus was shorter than that of white thrombus and mixed thrombus.RBC-rich thrombus has better recanalization effect.