Abstract Details

Title Effects of Clot Maturation and Intravascular Ultrasound Characteristics on Effectiveness of Aspiration Thrombectomy

Topic Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 262

Objective

Background BACKGROUND: Relationship between clot maturation and time required to aspirate clots is not fully understood.

Design/Methods DESIGN/METHODS: Clots were formed by 3ml citrate-anticoagulated human venous blood was initiated by recalcification with CaCl2 86 [mu]l/3ml and 5U/ml of thrombin. The clots were matured in saline at room temperature at different time period (2h, 6h, 24h, 48h, 72h) and 10mm of clots in length were transferred into silicone vessels 3mm in diameter with saline. Subsequently, Penumbra perfusion catheter was used proximal to the clot after acquiring the ultrasound image by IVUS. The time to remove clots was defined by the time interval between initiating aspiration and the time when all the clots were aspirated. The gray scale median (GSM) measurement scale was referenced to GSM values of saline and silicone vessel.

Results RESULTS: A total of 50 clots were studied. The time to remove clots increased with increasing clot maturation with longest time recorded at 48 hours (2h: 1.83±0.62, 6h: 2.13±0.54, 24h: 3.43±2.19, 48h: 4.27±2.19, 72h: 1.95±0.28 sec, ANOVA p=0.001). In IVUS study, a total of 50 clots were studied. GSM values increased significantly with increasing clot maturation (2h: 34.5±4.8, 6h: 37.4±6.0, 24h: 35.3±5.2, 48h: 40.6±5.3, 72h: 27.8±8.8, ANOVA p=0.0007). The highest GSM value was observed in 48 hours (p=0.0144,) and the lowest in 72 hours (p=0.0476, t- test, compared to GSM after 2h). Time to remove clot significantly correlated with higher GSM values (echogenicity) as determined by IVUS (Linear Regression, R2=0.13, p=0.0091).

Conclusions CONCLUSIONS: The effectiveness of aspiration thrombectomy depends upon the stage of clot maturation. The echogenicity of the clots determined by IVUS can identify the stage of maturation and subsequent response to apiration thrombectomy.

Authors/Disclosures
Masaki Watanabe (University of Minnesota) PRESENTER	No disclosure on file
Shahram Majidi, MD (Icahn School of Medicine at Mount Sinai)	Dr. Majidi has nothing to disclose.
Akira Todo, MD (Home)	No disclosure on file
Amy R. Tso, MD	No disclosure on file
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
Yash Jalundhwala, PhD (AbbVie Inc)	Dr. Jalundhwala has received personal compensation for serving as an employee of AbbVie . An immediate family member of Dr. Jalundhwala has received personal compensation for serving as an employee of AbbVie . Dr. Jalundhwala has received stock or an ownership interest from AbbVie.
	No disclosure on file
Syeda L. Alqadri, MD (KabaFusion Holders LLC)	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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