Article Figures & Data
Figures
- Fig 1.
A, Macroscopic view of 2 different experimental clots. A novel experimental clot (fibrin-rich clot) (left) is prepared by manually excising the fibrin-rich layer of swine clot, which is created by natural sedimentation. Fibrin-rich clot shows more solid and elastic mechanical properties than conventional thrombin-induced experimental clot (erythrocyte-rich clot) (right). B, Microscopic view of the experimental clots versus thromboembolus recovered from a patient with acute stoke (H&E, original magnification ×40). A microscopic view of an erythrocyte-rich clot (left) demonstrates a thrombus composed predominantly of erythrocytes with interspersed fibrin and barium sulfate deposits. A thromboembolus recovered from a patient with stroke (center) shows distinct layers of fibrin, nucleated cells, and erythrocytes. A fibrin-rich clot (right) produces a layered pattern of fibrin, nucleated cells, and erythrocytes similar to that seen in the clot recovered from the patient with stroke (center). F indicates fibrin component; Arrows, the cellular component; E, the erythrocyte component.
- Fig 2.
Bar graphs showing the number of attempts required to achieve the angiographic end point in each treated vessel. Every target vessel in group A achieved recanalization of TIMI grade 2 or greater, whereas only 3 of 8 vessels achieved recanalization in group B. None of the treated vessels that underwent 5 attempts of retrieval demonstrated significant recanalization (1 vessel with TIMI 1 and 4 vessels with TIMI 0).
- Fig 3.
Angiographic findings of a target vessel occluded with an erythrocyte-rich clot and treated with MT. A, Preprocedural angiogram of a right superficial cervical artery (anteroposterior view) shows the branching pattern of the artery. B, Complete occlusion of the vessel was confirmed after injection of an erythrocyte-rich clot. C, A Merci clot retriever device (V2.5 firm) was deployed distal to the occlusion site, and clot retrieval was performed. D, A postprocedural angiogram shows recanalization of the treated artery. Small residual thrombi distal to the bifurcation of the artery are also seen (arrow).
- Fig 4.
Angiographic findings of a target artery occluded with a fibrin-rich clot and treated with MT. A, A preprocedural angiogram of a left superficial cervical artery shows its branching pattern. B, Complete occlusion of the vessel was confirmed after injecting a fibrin-rich clot. C, A Merci clot retriever device (V2.5 firm) was deployed distal to the clot, and clot retrieval was performed. D, After 5 attempts at clot retrieval, the postprocedural angiogram shows that the treated vessel remains occluded.
Tables
Comparison between the erythrocyte-rich clot group and the fibrin-rich clot group
Erythrocyte-Rich Clot (Group A) Fibrin-Rich Clot (Group B) Level of Significance Total No. of treated vessels 8 8 N/A Total No. of attempts (times) 14 34 P < .001 Average No. of attempts per vessel (times) 2.75 4.5 P < .001 Mean procedural time (min) 15.5 81.5 P < .01 Final TIMI grade 0 0 4 2 0 1 N/A 3 5 2 4 3 1 Note:—N/A indicates not applicable.
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