Neuroradiology - Interventional Radiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Department of Diagnostic and Interventional Neuroradiology, Hopital Guillaume et Rene Laennec, Nantes, France.
J Neurointerv Surg. 2019 Dec;11(12):1197-1200. doi: 10.1136/neurintsurg-2019-014905. Epub 2019 May 3.
Few case reports have considered the chromatic aspect of retrieved clots and the possible association with their underlying etiology.
The aim of our study was to analyze the frequency of the TOAST ischemic stroke typical (atrial fibrillation, dissection, atheroma) and atypical (infective endocarditis, cancer-related, valve-related thrombi) etiologies depending on the chromatic aspect of retrieved clots.
A total of 255 anonymized and standardized clot photos of consecutive patients treated by mechanical thrombectomy for acute ischemic stroke were included. A double-blind evaluation was performed by two senior interventional neuroradiologists, who classified the visual aspects of the clots into two main patterns: red/black or white. Main patient characteristics, distribution of underlying stroke etiologies, and outcomes were compared between the two study groups.
The inter-reader agreement for clot colors was excellent (k=0.78). Two hundred and thirty-three patients were classified as having red/black clots and 22 as having white clots. A statistically significant association (p=0.001) between atypical etiologies and white clots was observed.
White clots were significantly associated with atypical etiologies in this cohort,in particular, with infectious endocarditis.
很少有病例报告考虑过取回的血栓的颜色方面以及它们与潜在病因的可能关联。
我们的研究目的是分析根据取回的血栓的颜色特征，TOAST 缺血性中风典型（心房颤动、夹层、动脉粥样硬化）和非典型（感染性心内膜炎、与癌症相关、与瓣膜相关的血栓）病因的频率。
共纳入 255 名接受机械血栓切除术治疗急性缺血性中风的连续患者的匿名和标准化的血栓照片。两名资深介入神经放射学家进行了双盲评估，他们将血栓的视觉方面分为两种主要模式：红色/黑色或白色。比较了两组患者的主要特征、潜在中风病因分布和结局。
血栓颜色的读者间一致性非常好（k=0.78）。233 名患者被归类为红色/黑色血栓，22 名患者为白色血栓。在该队列中，非典型病因与白色血栓之间存在统计学显著关联（p=0.001）。
在该队列中，白色血栓与非典型病因显著相关，尤其是与感染性心内膜炎相关。
