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Intracranial non-occlusive intraluminal thrombus may indicate underlying etiology of large vessel occlusion in patients undergoing endovascular therapy

Authors
 Seong Hwa Jang  ;  Hyungjong Park  ;  Joonsang Yoo  ;  Jeong-Ho Hong  ;  Jin Soo Lee  ;  Seong-Joon Lee  ;  Yong-Won Kim  ;  Ji Man Hong  ;  Jin Wook Choi  ;  Dong-Hun Kang  ;  Yong-Sun Kim  ;  Yang-Ha Hwang  ;  Sung-Il Sohn 
Citation
 JOURNAL OF NEUROINTERVENTIONAL SURGERY, Vol.14(10) : 997-1001, 2022-10 
Journal Title
JOURNAL OF NEUROINTERVENTIONAL SURGERY
ISSN
 1759-8478 
Issue Date
2022-10
MeSH
Atrial Fibrillation* / complications OR Endovascular Procedures* OR Humans OR Intracranial Thrombosis* / complications OR Stroke* / therapy OR Thrombectomy OR Tissue Plasminogen Activator
Keywords
atherosclerosis ; stroke ; thrombectomy
Abstract
Background: The underlying etiology of intracranial non-occlusive intraluminal thrombus (iNOT) remains unknown. This study aimed to investigate whether the presence of iNOT can indicate the underlying etiology of large vessel occlusion (LVO) in patients undergoing endovascular therapy (EVT).

Methods: Among patients who underwent EVT at three comprehensive stroke centers, we included those with intracranial LVO in the anterior circulation. The presence of iNOT was determined by pretreatment DSA. We investigated the association between iNOT and intracranial atherosclerotic stenosis (ICAS) related LVO.

Results: Of 546 patients, 44 (8.1%) had iNOT. Patients with iNOT were younger, had less hypertension, atrial fibrillation, and a history of antiplatelet use. In addition, the involvement of the M1 segment of the middle cerebral artery (MCA) was more frequent. However, they had a lower National Institutes of Health Stroke Scale (NIHSS) score on admission and longer onset to recanalization time compared with patients with no iNOT. In a logistic regression model adjusting for age, sex, atrial fibrillation, smoking, prior antiplatelet and anticoagulant use, intravenous tissue plasminogen activator, NIHSS on admission, number of technical trials, intraprocedural re-occlusion, and the location of LVO (p<0.10 in the univariate analysis), the presence of iNOT was significantly associated with ICAS related LVO (adjusted OR 3.04; 95% CI 1.33 to 6.90; p=0.007).

Conclusions: The presence of iNOT may reflect an underlying ICAS related LVO in patients undergoing EVT.
Full Text
https://jnis.bmj.com/content/14/10/997.long
DOI
10.1136/neurintsurg-2021-017995
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Yoo, Joon Sang(유준상) ORCID logo https://orcid.org/0000-0003-1169-6798
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193295
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