Evidence map›Paper›PMID 34911736›Full record

ArticleJournal of neurointerventional surgery2022

Quantification of clot spatial heterogeneity and its impact on thrombectomy.

Yang Liu, Waleed Brinjikji, Mehdi Abbasi, Daying Dai, Jorge L Arturo Larco, Sarosh Irfan Madhani, Adnan H Shahid, Oana Madalina Mereuta, Raul G Nogueira, Peter Kvamme and 32 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurointerventional surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. A novel method for preparing clot analogs under dynamic vortical flow for testing mechanical thrombectomy devices.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

42 authors.

Yang LiuRadiology, Mayo Clinic, Rochester, Minnesota, USA yliume@umich.edu.ORCID http://orcid.org/0000-0002-9132-0258
Waleed BrinjikjiRadiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0001-5271-5524
Mehdi AbbasiRadiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0001-6978-2563
Daying DaiRadiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0003-4051-6450
Jorge L Arturo LarcoNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0002-8259-2681
Sarosh Irfan MadhaniNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Adnan H ShahidNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Oana Madalina MereutaRadiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0003-3741-3784
Raul G NogueiraNeurology, Emory University School of Medicine, Atlanta, Georgia, USA.
Peter KvammeRadiology, University of Tennessee Medical Center, Knoxville, Tennessee, USA.
Kennith F LaytonNeuroInterventional Radiology, Baylor University Medical Center, Dallas, Texas, USA.
Josser E Delgado AlmandozNeuroInterventional Radiology, Abbot Northwestern Hospital, Minneapolis, Minnesota, USA.
Ricardo A HanelNeurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.
Vitor Mendes PereiraDivision of Neuroradiology, Department of Medical Imaging and Division of Neurosurgery, Department of Surgery, University Health Network - Toronto Western Hospital, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-6804-3985
Mohammed A AlmekhlafiDepartments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID http://orcid.org/0000-0001-9550-8197
Albert J YooNeurointervention, Texas Stroke Institute, Plano, Texas, USA.
Babak S JahromiRadiology and Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID http://orcid.org/0000-0001-5064-5278
Matthew J GounisRadiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA.ORCID http://orcid.org/0000-0002-8034-2785
Biraj PatelRadiology and Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA.
Seán FitzgeraldDepartment of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.ORCID http://orcid.org/0000-0001-6634-092X
Karen DoyleDepartment of Physiology and CURAM-SFI Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.ORCID http://orcid.org/0000-0001-8984-6296
Diogo C HaussenNeurology, Emory University School of Medicine, Atlanta, Georgia, USA.
Alhamza R Al-BayatiNeurology, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0001-8103-1930
Mahmoud MohammadenNeurology, Emory University School of Medicine, Atlanta, Georgia, USA.
Leonardo PisaniNeurology, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0003-0300-6355
Gabriel Martins RodriguesNeurology, Emory University School of Medicine, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0002-9152-0882
Ike C ThackerNeuroInterventional Radiology, Baylor University Medical Center, Dallas, Texas, USA.
Yasha KayanNeuroInterventional Radiology, Abbot Northwestern Hospital, Minneapolis, Minnesota, USA.
Alexander CopelanNeuroInterventional Radiology, Abbot Northwestern Hospital, Minneapolis, Minnesota, USA.
Amin AghaebrahimNeurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.ORCID http://orcid.org/0000-0002-9126-2932
Eric SauvageauNeurosurgery, Baptist Medical Center, Jacksonville, Florida, USA.
Andrew M DemchukDepartments of Clinical Neurosciences, Radiology, and Community Health Sciences, Hotchkiss Brain Institute and Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Parita BhuvaNeurointervention, Texas Stroke Institute, Plano, Texas, USA.
Jazba SoomroNeurointervention, Texas Stroke Institute, Plano, Texas, USA.
Pouya NazariRadiology and Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.ORCID http://orcid.org/0000-0003-1135-1095
Donald Robert CantrellRadiology and Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Ajit S PuriRadiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
John EntwistleRadiology and Neurosurgery, Carilion Clinic, Roanoke, Virginia, USA.
Ramanathan KadirvelRadiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0002-6786-9953
Harry J CloftRadiology, Mayo Clinic, Rochester, Minnesota, USA.
David F KallmesRadiology, Mayo Clinic, Rochester, Minnesota, USA.
Luis SavastanoRadiology, Mayo Clinic, Rochester, Minnesota, USA.

Funding

Impact of Clot Histological and Physical Properties on Revascularization Strategies in Acute Ischaemic Stroke - Administrative SupplementR01NS105853 · NINDS · MAYO CLINIC ROCHESTER · PI BRINJIKJI, WALEED · 2018 to 2022
$2.0M
NINDS NIH HHS R01 NS105853
6 · The paper itself

Abstract

backgroundCompositional and structural features of retrieved clots by thrombectomy can provide insight into improving the endovascular treatment of ischemic stroke. Currently, histological analysis is limited to quantification of compositions and qualitative description of the clot structure. We hypothesized that heterogeneous clots would be prone to poorer recanalization rates and performed a quantitative analysis to test this hypothesis.

methodsWe collected and did histology on clots retrieved by mechanical thrombectomy from 157 stroke cases (107 achieved first-pass effect (FPE) and 50 did not). Using an in-house algorithm, the scanned images were divided into grids (with sizes of 0.2, 0.3, 0.4, 0.5, and 0.6 mm) and the extent of non-uniformity of RBC distribution was computed using the proposed spatial heterogeneity index (SHI). Finally, we validated the clinical significance of clot heterogeneity using the Mann-Whitney test and an artificial neural network (ANN) model.

resultsFor cases with FPE, SHI values were smaller (0.033 vs 0.039 for grid size of 0.4 mm, P=0.028) compared with those without. In comparison, the clot composition was not statistically different between those two groups. From the ANN model, clot heterogeneity was the most important factor, followed by fibrin content, thrombectomy techniques, red blood cell content, clot area, platelet content, etiology, and admission of intravenous tissue plasminogen activator (IV-tPA). No statistical difference of clot heterogeneity was found for different etiologies, thrombectomy techniques, and IV-tPA administration.

conclusionsClot heterogeneity can affect the clot response to thrombectomy devices and is associated with lower FPE. SHI can be a useful metric to quantify clot heterogeneity.

Indexed as

Brain IschemiaStrokeThrombosisFibrinHumansThrombectomyTissue Plasminogen ActivatorFibrinTissue Plasminogen Activatorinterventionstroketechnologythrombectomy

Identifiers

PMID34911736
PMCPMC11178127

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.