Thrombotic Pathology is not Correlated with the Prognosis of Endovascular Treatment for Acute Ischemic Stroke.

Abstract Objective The aim of the present study was to determine whether there is a correlation between thrombotic pathology and prognosis of endovascular treatment (EVT) for acute ischemic stroke (AIS). Methods Thrombi were taken from 58 patients with cerebral ischemic thrombosis who were consecutively selected for EVT for AIS. The collected thrombi then underwent hematoxylin-eosin staining for pathological examinations to determine the red blood cell (RBC) ratio and fibrin/platelet components. The patients were divided into the following three groups according to their proportions of RBCs in thrombi: RBC-rich group (RBC ratio ≥ 70%), mixed group (RBC ratio at 31–69%), and fibrin/platelet-rich group (RBC ratio ≤ 30%). Prognosis was classified into good (0–2 points on modified Rankin scale [mRS] at postoperative 90 days) and poor (3–6 points on mRS at postoperative 90 days). Correlational analysis was performed between thrombotic pathology and prognosis of EVT for AIS. Results Among all patients, the distributions were as follows: 18.96% (11/58) patients in the RBC-rich group, 63.79% (37/58) patients in the mixed group, and 17.24% (10/58) patients in the fibrin/platelet-rich group. In addition, 43.10% (25/58) of the patients had good prognosis and 56.90% (33/58) had poor prognosis.There was no statistically significant difference between the good prognosis and the poor prognosis in the RBC-rich group, the mixed group, and the fibrin/platelet-rich group (P=0.713, 0.829, 0.748).Multivariate logistic regression analysis to explored the association between RBC-rich group and good prognosis while adjusting for other baseline prognostic factors (age, ASPECTS, NIHSS score, and PRT and intravenous alteplase-bridging therapy). Compared to the fibrin/platelet-rich group, the odds ratio(OR) of achieving good prognosis was 0.60 (P = 0.592) for the mixed group and OR = 0.74 (P = 0.793) for the RBC-rich group.Notably, age was found to be negatively associated with good prognosis (OR = 0.91, P = 0.013). The ASPECTS score was found to be positively associated with good prognosis (OR = 2.01, P = 0.002). Alteplase bridging was associated with a marginally significant positive association with good prognosis (OR = 4.23, P = 0.083). Conclusions No correlation was found between thrombotic pathology and prognosis of EVT for AIS. Good prognosis after endovascular treatment was associated with low age, high ASPECTS at admission, and alteplase bridging.