Two‐layered susceptibility vessel sign is associated with biochemically quantified thrombus red blood cell content

Meglio, Lucas Di; Derraz, Imad; Solo-Nomenjanahary, Mialitiana; Daly, Don S.; Rd, Santos Filho; Maacha, Malek Ben; Labreuche, Julien; Desal, Hubert; Consoli, Arthuro; Lapergue, Bertrand; Blanc, Raphaël; Piotin, Michel; Mazighi, Mikaël; Ho‐Tin‐Noé, Benoît; Desilles, Jean‐Philippe; Bourcier, Romain; Redjem, Hocine; Smajda, Stanislas; Cicciò, Gabriele; Fahed, Robert; Escalard, Simon; Hamdani, Mylène; Sabben, Candice; Obadia, Michaël; Deschildre, Catherine; Hébert, Solène; Rodesch, Georges; Maria, Federico Di; Coskun, Okuzan; Lopez, Delphine; Détraz, Lili; Roy, Monica; Clavier, Delphine; Marnat, Gaultier; Gariel, Florent; Lucas, Ludovic; Sibon, Igor; Eugène, François; Vannier, Stéphane; Ferré, Jean-Christophe; Lebras, Anthony; Raoult, Hélène; Paya, Christophe; Gauvrit, Jean‐Yves; Richard, Sébastien; Gory, Benjamin; Delvoye, François; Maïer, Benjamin

doi:10.1111/ene.14241

Cited by 8 publications

(4 citation statements)

References 18 publications

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“…In our whole cohort, 79.4% of patients presented with an SVS, which is in line with data reported in recent studies (71 to 86% of patients) ( 2 , 7 , 17 , 40 – 42 ).…”

Section: Discussionsupporting

confidence: 93%

Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy

et al. 2022

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Background and PurposeThe presence of a Susceptibility Vessel Sign (SVS) in the acute phase of proximal occlusion ischemic stroke indicates the presence of deoxyhemoglobin in the thrombus. Thrombi composition changes over time. The aim of this study was to investigate whether the absence of SVS is associated with a shorter symptom onset to imaging time.MethodsWe retrospectively analyzed all patients referred for mechanical thrombectomy at Besançon University Hospital between 1 January 2015 and 31 December 2020 for whom readable T2*-weighted imaging was available. We compared patient characteristics according to the presence or absence of an SVS. We also studied the subgroup for whom the exact symptom onset time was known. We performed a univariate statistical analysis, then a multivariate analysis on the variables that were statistically significant in the univariate analysis.ResultsOf the 389 patients included, 309 (79.4%) were SVS+. We found no significant relationship between SVS– and the time between symptom onset and imaging in the whole cohort. In the multivariate analysis, SVS– was associated with anticoagulant treatment (p < 0.01), and SVS+ with age (p = 0.023) and carotid terminus occlusion (p = 0.042). In the known symptom onset subgroup, SVS– was significantly associated with a shorter symptom onset -imaging time (p < 0.001), and this was confirmed in the multivariate analysis (p = 0.011; OR 0.911; 95% CI [0.844; 0.972]).ConclusionIn the acute phase of proximal occlusion ischemic stroke, absence of SVS was associated with a shorter symptom onset–imaging time for patients with a known symptom onset time.

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“…In our whole cohort, 79.4% of patients presented with an SVS, which is in line with data reported in recent studies (71 to 86% of patients) ( 2 , 7 , 17 , 40 – 42 ).…”

Section: Discussionsupporting

confidence: 93%

Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy

et al. 2022

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“…1 A quantitative method on whole thrombus homogenates with specific measurement of thrombus components may help to overcome these limitations. 31 Last, the T2* value is dependent on magnetic field strength, and the next step is to analyze the inter-MR imaging machine agreement for this sequence.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging quantitative T2* mapping to predict the red blood cell content of in vivo thrombi retrieved from patients with large vessel occlusions in acute ischemic stroke

et al. 2021

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Background and purpose Magnetic resonance imaging quantitative T2* mapping has shown reliable identification of thrombus red blood cell content in vitro. The thrombus composition has been in vivo, associated with outcomes after endovascular therapy for acute ischemic stroke. We aim to analyze the red blood cell content of thrombi retrieved from patients with large vessel occlusions in relation to the thrombus-T2* relaxation time in magnetic resonance imaging. Material and methods Consecutive acute ischemic stroke patients treated by endovascular therapy were scanned with an magnetic resonance imaging quantitative T2* mapping sequence. Quantitative histologic evaluations of red blood cell content were performed. A linear regression assessed the association between vascular risk factors, comorbidities, antithrombotic drugs intake, baseline National Institutes of Health Stroke Scale (NIHSS), intravenous thrombolysis before endovascular therapy, time between onset and groin puncture, patient's outcome at 3 months, magnetic resonance imaging quantitative T2* mapping results, and the red blood cell content of thrombi. The correlation between the mean thrombus-T2* relaxation time and red blood cell content was assessed by calculating the Pearson correlation coefficient. Results Among 31 thrombi, 16 were “Fibrin rich” and 15 “red blood cell dominant.” The median red blood cell content was 39 (range, 0–90; interquartile range, 37). The median (interquartile range) thrombus-T2* relaxation time was shorter in “red blood cell dominant” thrombi (21, interquartile range 6) than in “Fibrin rich” thrombi (24, interquartile range 7), without significant difference ( p = 0.15), as shown in the Box plot. An inverse correlation between thrombus-T2* relaxation time and red blood cell content was found, with a correlation coefficient of −0.41 (95% CI, −0.67 to −0.08, p = 0.02). Conclusion Our study shows that a shorter thrombus-T2* relaxation time is related to a higher red blood cell content within in vivo thrombi.

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“…[22], в соответствии с которыми МРТпаттерн при криптогенном инсульте не связан с вероятностью выявления ФП при интракардиальном мониторинге, хотя данный вывод следует считать преждевременным ввиду малого числа пациентов в группе ПКМ-КЭИ. Примечательно, что у пациентов с ПКМ-КЭИ в 9 раз чаще наблюдался симптом «черной артерии» (SVS), который характерен для «красных» тромбоэмболов с высоким содержанием эритроцитов [23]. Прогностическая точность данного клиниче-значение эдоксабана при наличии только ЭКГ-критериев ПКМ (предсердные эпизоды высокой частоты) не влияло на частоту ишемических событий, однако увеличивало риск кровотечений [16].…”

Section: сравнение пациентов в зависимости от наличия пкм-кэи по клин...unclassified

Atrial cardiomyopathy in patients with cryptogenic embolic stroke: incidence, instrumental diagnostic features, impact on prognosis

Chazov,

Mekhryakov,

Kulesh

et al. 2023

RJTAO

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Latent atrial fibrillation (AF), whose substrate is atrial cardiomyopathy (AC), is considered the main potential pathogenetic mechanism of cryptogenic embolic stroke (CES). Early detection of AC allows to intensify the search for AF in such patients.Objective: to compare the characteristics of patients with CES in terms of clinical and anamnestic data, echocardiographic parameters, MRI patterns of infarction foci and disease outcomes depending on the presence of the major markers for AC.Material and methods. We studied 103 patients in the acute phase of CES with a lesion confirmed by MRI data, who were divided into two groups according to the presence (n=17) or absence (n=86) of AC. A comprehensive clinical, laboratory, and instrumental examination was performed and long-term outcomes were assessed. The median follow-up period was 32 months.Results. The incidence of AC in the CES population was 17%; the most common markers were an increase in left atrial volume index and paroxysms of supraventricular tachycardia. Patients with AC-CES were characterised by older age and a two-fold increase in the prevalence of coronary heart disease. Patients with AC-CES were nine times more likely to have a "black artery" symptom on MRI than patients without AC. The predictive accuracy of this clinical pattern was 84%, the sensitivity was 60% and the specificity was 86%. Patients with AC-CES had a significantly higher risk (odds ratio 3.4; 95% confidence interval 1.1–9.9; p=0.023) for a composite outcome that included the development of recurrent ischemic stroke, transient ischemic attack, myocardial infarction or death.Conclusion. AC diagnosed by a combination of echocardiographic and electrocardiographic signs is present in 17% of patients with CES. Patients with AC-CES are characterised by elderly age, the presence of atherosclerosis-associated disease, a specific MRI pattern (the “black artery” symptom) and an unfavourable prognosis during the 2.5-year follow-up period.

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Two‐layered susceptibility vessel sign is associated with biochemically quantified thrombus red blood cell content

Cited by 8 publications

References 18 publications

Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy

Factors That Influence Susceptibility Vessel Sign in Patients With Acute Stroke Referred for Mechanical Thrombectomy

Magnetic resonance imaging quantitative T2* mapping to predict the red blood cell content of in vivo thrombi retrieved from patients with large vessel occlusions in acute ischemic stroke

Atrial cardiomyopathy in patients with cryptogenic embolic stroke: incidence, instrumental diagnostic features, impact on prognosis

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