Granulocytes-Rich Thrombi in Cerebral Large Vessel Occlusion Are Associated with Increased Stiffness and Poorer Revascularization Outcomes
Juega, Jesus (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Li, Jiahui (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Palacio-García, Carles (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodriguez, Maite (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Tiberi, Riccardo (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Piñana, Carlos (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodriguez-Luna, David (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Requena, Manuel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
García-Tornel, Álvaro (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodriguez-Villatoro, Noelia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rubiera Del Fueyo, Marta A (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Muchada, Marian (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Olivé-Gadea, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rizzo, Federica (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Hernandez, David (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Dios-Lascuevas, Marta (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Hernández-Pérez, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Dorado Bouix, Laura (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Quesada, Helena (Hospital Universitari de Bellvitge)
Cardona, Pere-Joan (Hospital Universitari de Bellvitge)
De La Torre, Carolina (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Gallur, Laura (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Camacho, Jessica (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ramón y Cajal, Santiago (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Tomasello, Alejandro (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Ribo, Marc (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Molina, Carlos A. (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Pagola, Jorge (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	We aim to identify a profile of intracranial thrombus resistant to recanalization by mechanical thrombectomy (MT) in acute stroke treatment. The first extracted clot of each MT was analyzed by flow cytometry obtaining the composition of the main leukocyte populations: granulocytes, monocytes, and lymphocytes. Demographics, reperfusion treatment, and grade of recanalization were registered. MT failure (MTF) was defined as final thrombolysis in cerebral infarction score IIa or lower and/or need of permanent intracranial stenting as a rescue therapy. To explore the relationship between stiffness of intracranial clots and cellular composition, unconfined compression tests were performed in other cohorts of cases. Thrombi obtained in 225 patients were analyzed. MTF were observed in 30 cases (13%). MTF was associated with atherosclerosis etiology (33. 3% vs. 15. 9%; p = 0. 021) and higher number of passes (3 vs. 2; p < 0. 001). Clot analysis of MTF showed higher percentage of granulocytes [82. 46 vs. 68. 90% p < 0. 001] and lower percentage of monocytes [9. 18% vs. 17. 34%, p < 0. 001] in comparison to successful MT cases. The proportion of clot granulocytes (aOR 1. 07; 95% CI 1. 01-1. 14) remained an independent marker of MTF. Among thirty-eight clots mechanically tested, there was a positive correlation between granulocyte proportion and thrombi stiffness (Pearson's r = 0. 35, p = 0. 032), with a median clot stiffness of 30. 2 (IQR, 18. 9-42. 7) kPa. Granulocytes-rich thrombi are harder to capture by mechanical thrombectomy due to increased stiffness, so a proportion of intracranial granulocytes might be useful to guide personalized endovascular procedures in acute stroke treatment. Supplementary Information: The online version contains supplementary material available at 10. 1007/s13311-023-01385-1.
Note:	Altres ajuts: acords transformatius de la UAB
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Acute stroke ; Flow cytometry ; Granulocytes ; Mechanical thrombectomy ; Recanalization ; Thrombi
Published in:	Neurotherapeutics, Vol. 20 (may 2023) , p. 1167-1176, ISSN 1878-7479

DOI: 10.1007/s13311-023-01385-1
PMID: 37212981

10 p, 787.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Josep Carreras Leukaemia Research Institute
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