CENTRUM
MEDISCHE BEELDVORMING
ARTIKELS ABSTRACT 1 Delayed post-anoxic white matter injury in an infant. Degrieck B, Dutoit J, Herregods N Journal of the Belgian Society of Radiology, 2020, 104(1), 31
ABSTRACT Case report teaching point: White matter reversal on diffusion-weighted magnetic resonance imaging is indicative of delayed post-anoxic encephalopathy. This manifests sooner in young infants than in adults.
with mTICI-2B reperfusion. On multivariate analysis VLLC was inversely associated with excellent outcomes (odds ratio 0.075, 95% confidence interval 0.007-0.765, P = 0.029) but not associated with mortality.
CONCLUSION The mTICI-2B grade may be further refined by secondary radiological markers. The VLLC sign is associated with the loss of excellent functional outcomes at 3 months. It is a simple sign to discriminate mTICI-2B into different grades but should be verified in larger populations from other centers.
ABSTRACT 3 ABSTRACT 2 Very late leptomeningeal collaterals-potential new way to subdivide modified thrombolysis in cerebral ischemia (mTICI) 2B. Yeo L, Cervo A, Gopinathan A, Andersson T, et al. Clinical Neuroradiology, 2020, 30(1), 77-83
INTRODUCTION Studies have shown that the modified thrombolysis in cerebral ischemia (mTICI) 2B score is associated with better functional outcome; however, 50-99% reperfusion is a large range and there may be factors which can differentiate this further. The effects of very late leptomeningeal collaterals (VLLC) on mTICI-2B patients were studied.
Structural analysis of ischemic stroke thrombi: histological indications for therapy resistance. Staessens S, Denorme F, François O, Andersson T, et al. Haematologica, 2020, 105(2), 498-507
ABSTRACT Ischemic stroke is caused by a thromboembolic occlusion of cerebral arteries. Treatment is focused on fast and efficient removal of the occluding thrombus, either via intravenous thrombolysis or via endovascular thrombectomy. Recanalization, however, is not always successful and factors contributing to failure are not completely understood. Although the occluding thrombus is the primary target of acute treatment, little is known about its internal organization and composition.
MATERIALS/METHODS A prospectively collected registry of anterior circulation AIS patients treated with the EmboTrap revascularization device from 2013 to 2016 was evaluated. Imaging parameters and timings, including the mTICI score were verified by an external core laboratory blinded to the clinical data. The final angiogram was examined for the appearance of VLLC in predicting 3‑month outcomes including excellent functional outcomes, defined as modified Rankin scale (mRS) 0-1, bleeding risk and mortality.
The aim of this study, therefore, was to better understand the internal organization of ischemic stroke thrombi on a molecular and cellular level.
RESULTS
Our results show that stroke thrombi are composed of two main types of areas: RBC-rich areas and platelet-rich areas. RBC-rich areas have limited complexity as they consist of RBC that are entangled in a meshwork of thin fibrin. In contrast, platelet-rich areas are characterized by dense fibrin structures aligned with vWF and abundant amounts of leukocytes and DNA that accumulate around and in these platelet-rich areas. These findings are important to
A total of 177 consecutive anterior circulation stroke patients were included in the analysis. Of these 94 (53.1%) achieved only mTICI-2B reperfusion, 16/94 (17.0%) patients achieved excellent functional outcomes at 3 months and 26 (27.7%) had hyperdensity on follow-up computed tomography (CT). On univariate analysis, the presence of VLLC was inversely associated with excellent functional outcomes at 3 months and positively associated with mortality in patients
34 ABSTRACTBOEK | 2020
A total of 188 thrombi were collected from endovascularly treated ischemic stroke patients and analyzed histologically for fibrin, red blood cells (RBC), von Willebrand factor (vWF), platelets, leukocytes and DNA, using bright field and fluorescence microscopy.
