MR microscopy to assess clot composition following mechanical thrombectomy predicts recanalization and clinical outcome
Motivation: Mechanical thrombectomy (MT) is the standard for ischemic stroke with large vessel occlusion (LVO). Clot composition is underexplored in clinical practice, leading to standardized MT regardless of clot type. Goal(s): This single-center study examined clot composition in 60 LVO stroke patients using high-field MRI at 9.4T ("MR-microscopy"). Approach: MR microscopy correlated with histopathology, and quantifying the hyperdense artery sign (HAS) on pre-interventional CT further stratified clot composition. Results: MR microscopy successfully identified clot types—red (23%), white (28%), or mixed (48%)—with 95.4% accuracy. White clots required more passes during MT, had worse clinical outcomes, while red clots showed better first-pass recanalization rates. Impact: This study suggests clot imaging can personalize MT for improved outcomes in LVO stroke patients.
Authors
- Gregor Bauer
- Tobias Charlet
- Jessica Jesser (ORCID: https://orcid.org/0000-0002-1236-8828)
- Tim Hilgenfeld (ORCID: https://orcid.org/0000-0002-3458-8899)
- Dominik F. Vollherbst (ORCID: https://orcid.org/0000-0002-8992-4757)
- Martin Bendszus (ORCID: https://orcid.org/0000-0002-9094-6769)
- Michael O. Breckwoldt (ORCID: https://orcid.org/0000-0002-9980-2390)
- Ulf Neuberger (ORCID: https://orcid.org/0000-0002-3085-3886)
- Fabian Preisner (ORCID: https://orcid.org/0000-0003-0314-6761)
- Stefan Hamelmann (ORCID: https://orcid.org/0009-0002-1745-6728)
- Anna Kocharyan (ORCID: https://orcid.org/0000-0003-4292-9128)
- Peter A. Ringleb (ORCID: https://orcid.org/0000-0002-5473-8671)
- Christian Herweh (ORCID: https://orcid.org/0000-0002-9223-9662)
- Christian Ulfert (ORCID: https://orcid.org/0000-0003-3642-350X)
- Lucas Schirmer (ORCID: https://orcid.org/0000-0001-7142-4116)
- Dániel Schwarz (ORCID: https://orcid.org/0000-0002-9017-8245)
- Niclas Schmitt (ORCID: https://orcid.org/0000-0003-2509-5459)
- Felix Sahm (ORCID: https://orcid.org/0000-0001-5441-1962)
- Katharina Schregel (ORCID: https://orcid.org/0000-0003-4367-1667)
- Sabine Heiland (ORCID: https://orcid.org/0000-0002-2796-3451)
- Wolfgang Wick (ORCID: https://orcid.org/0000-0002-6171-634X)
- Kianush Karimian‐Jazi (ORCID: https://orcid.org/0000-0002-5550-0489)
- Manuel Fischer (ORCID: https://orcid.org/0000-0001-7459-1024)
- Volker Sturm (ORCID: https://orcid.org/0000-0001-8681-9372)
- Markus Möhlenbruch
- Fatih Şeker
Publication Details
- Journal
- Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition
- Published
- 2024-11-26
- DOI
- https://doi.org/10.58530/2024/0082
- Primary Topic
- Acute Ischemic Stroke Management
- Type
- article
- Field-Weighted Citation Impact
- 0.00