The proportion of platelets in intracranial thrombus was determined to be an independent marker of first pass recanalization (FPR), according to analysis results presented at the 2022 International Stroke Conference 2022.

Jesus Juega, MD, neurologist at the Hospital Universitari Vall d’Hebron, presented the abstract on Friday, February 11.

After obtaining intracranial thrombi via mechanical thrombectomy (MT), Spanish researchers divided each thrombus into two parts — one part was analyzed using anatomopathological studies to quantify fibrin, red-blood cells, and platelets while the other part was analyzed using flow cytometry to quantify leukocyte populations and their relative proportions. FPR was defined as ≥mTICI 2b after first pass in MT. Outcomes compared between the FPR and non-FPR groups were as follows: thrombus composition, baseline variables (demographics, previous use of antiplatelets or anticoagulants, blood pressure and blood glucose at hospital arrival), etiology, intravenous fibrinolysis, ASPECTS score, and first attempt thrombectomy devices (direct aspiration, stent retriever or combinations).

A total of 76 cases were analyzed, with 50% (n = 38) having obtained FPR. Of those with FPR, the thrombi obtained presented a higher proportion of red blood cells (33.64% vs 18.16% P = 0.048) and lymphocytes (10.07% vs 4.43% P = 0.042), as well as a lower proportion of platelets (61, 48% vs 67.26% P = 0.042), when compared to the non-FPR group. There were no differences in baseline variables, etiology, ASPECTS scores, previous use of fibrinolysis, or type of device used for MT between the groups. The researchers found the proportion of platelets to be an independent marker of FPR (OR 0.97; CI 0.95-0.99). Additionally, “there was an inverse correlation between the proportion of platelets and lymphocytes (rho -0.44, P <0.001),” authors wrote.

The inverse relationship between proportion of platelets and lymphocytes presents a potential target for future reperfusion treatments.

Reference:

Juega J, Palacio C, Piñana C, et al. Thrombus composition is associated with first pass recanalization. Abstract presented at: International Stroke Conference; February 9-11, 2022; New Orleans, LA, US.