scholarly journals The Role of von Willebrand Factor, ADAMTS13, and Cerebral Artery Thrombus Composition in Patient Outcome Following Mechanical Thrombectomy for Acute Ischemic Stroke

2018 ◽  
Vol 24 ◽  
pp. 3929-3945 ◽  
Author(s):  
Vaclav Prochazka ◽  
Tomas Jonszta ◽  
Daniel Czerny ◽  
Jan Krajca ◽  
Martin Roubec ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Von Willebrand ◽  
Willebrand Factor

Clinical role of von Willebrand factor in acute ischemic stroke

2017 ◽  
Vol 129 (13-14) ◽  
pp. 491-496 ◽  
Author(s):  
Marija Menih ◽  
Miljenko Križmarić ◽  
Tanja Hojs Fabjan
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Clinical Role ◽  
Von Willebrand ◽  
Willebrand Factor

scholarly journals Detailed histological analysis of a thrombectomy-resistant ischemic stroke thrombus: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Senna Staessens ◽  
Olivier François ◽  
Linda Desender ◽  
Peter Vanacker ◽  
Tom Dewaele ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Histological Analysis ◽  
Mechanical Thrombectomy ◽  
Neutrophil Extracellular Traps ◽  
Extracellular Dna ◽  
Extracellular Traps ◽  
First Pass ◽  
Von Willebrand ◽  
Willebrand Factor

Abstract Background Mechanical removal of a thrombus by thrombectomy can be quite challenging. For reasons that are not fully understood, some thrombi require multiple passes to achieve successful recanalization, whereas other thrombi are efficiently removed in a single pass. Since first pass success is associated with better clinical outcome, it is important to better understand the nature of thrombectomy resistant thrombi. The aim of this study was therefore to characterize the cellular and molecular composition of a thrombus that was very hard to retrieve via mechanical thrombectomy. Case presentation In a patient that was admitted with a right middle cerebral artery M1-occlusion, 11 attempts using various thrombectomy devices and techniques were required for removal of the thrombus. This peculiar case provided a rare opportunity to perform an in-depth histopathological study of a difficult to retrieve thrombus. Thrombus material was histologically analyzed using hematoxylin and eosin, Martius Scarlet Blue stain (red blood cells and fibrin), Feulgen stain (DNA), von Kossa stain (calcifications) and immunohistochemical analysis of von Willebrand factor, platelets, leukocytes and neutrophil extracellular traps. Histological analysis revealed abnormally high amounts of extracellular DNA, leukocytes, von Willebrand factor and calcifications. Extracellular DNA stained positive for markers of leukocytes and NETs, suggesting that a significant portion of DNA is derived from neutrophil extracellular traps. Conclusion In this unique case of a nearly thrombectomy-resistant stroke thrombus, our study showed an atypical composition compared to the common structural features found in ischemic stroke thrombi. The core of the retrieved thrombus consisted of extracellular DNA that colocalized with von Willebrand factor and microcalcifications. These results support the hypothesis that von Willebrand factor, neutrophil extracellular traps and microcalcifications contribute to mechanical thrombectomy resistance. Such information is important to identify novel targets in order to optimize technical treatment protocols and techniques to increase first pass success rates.

scholarly journals The role of diabetes mellitus on the thrombus composition in patients with acute ischemic stroke

2020 ◽  
Vol 26 (3) ◽  
pp. 329-336 ◽  
Author(s):  
Gengfan Ye ◽  
Qun Gao ◽  
Peng Qi ◽  
Junjie Wang ◽  
Shen Hu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Ischemic Stroke ◽  
Red Blood Cells ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Blood Cells ◽  
Smoking History ◽  
Diabetic Patients ◽  
Von Willebrand ◽  
Willebrand Factor

Purpose Diabetes mellitus indicated poor clinical prognosis for patients with acute ischemic stroke. Furthermore, diabetes mellitus could also impact the hemostatic system, while its influence on the histological composition of thrombus is unclear. Methods Consecutive patients with retrieved clots were included. Histologic staining for thrombus included hematoxylin and eosin, Martius Scarlet Blue, immunohistochemistry for von Willebrand factor. The differences in clot composition were compared according to diabetes mellitus history or hyperglycemia (≥7.8 mmol/L) on admission. Results A total of 52 patients were included; half of them were diagnosed as diabetes mellitus previously. Diabetic patients showed higher serum glucose on admission (8.90 vs. 7.40, p = 0.012). The baseline characteristics (expect smoking history and thrombus location), procedural, and clinical outcomes were similar between diabetic patients and nondiabetic patients. As for histologic composition, thrombus in patients with diagnosed diabetes mellitus had more fibrin (44.2% vs. 28.3%, p = 0.004) and fewer red blood cells (26.0% vs. 42.9%, p = 0.013) and equivalent content of platelets (24.0% vs. 21.5%, p = 0.694) and von Willebrand factor (0.041 vs. 0.031, p = 0.234) than patients without diabetes mellitus. However, there was no statistical difference in the content of red blood cells (41.6% vs. 27.3%, p = 0.105), fibrin (37.6% vs. 34.3%, p = 0.627), platelets (21.2% vs. 24.2%, p = 0.498), and von Willebrand factor (0.038 vs. 0.034, p = 0.284) between patients with or without hyperglycemia on admission. Conclusion Clots in diabetic patients had more fibrin and fewer erythrocyte components compared with patients without diabetes mellitus, while hyperglycemia on admission did not show association with clot composition. Further studies are needed to confirm these results.

Abstract WP268: Von Willebrand Factor Expression in Various Subtypes of Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Oana M Mereuta ◽  
Sean Fitzgerald ◽  
Mehdi Abbasi ◽  
Daying Dai ◽  
Ramanathan Kadirvel ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Cryptogenic Stroke ◽  
Cardioembolic Stroke ◽  
Unknown Etiology ◽  
Learning Software ◽  
Von Willebrand ◽  
The Relationship ◽  
Willebrand Factor

Introduction: Von Willebrand factor (VWF) is a key component of acute ischemic stroke (AIS) thrombi. The aim of our prospective study was to investigate the immunohistochemical expression of VWF in clots and to evaluate whether VWF is associated with certain subtypes of AIS. Methods: VWF immunostaining was performed on 79 thrombi collected as part of the multi-center Stroke Thromboembolism Registry of Imaging and Pathology (STRIP) registry. The cases were classified according to TOAST criteria. The VWF expression was quantified using Orbit Image Analysis (www.Orbit.bio) machine learning software. IBM SPSS statistics 25 was used to assess the relationship between the VWF levels and different etiology subtypes. Results: A cardioembolic stroke was defined in 39 cases (49.4%) whereas an atherosclerotic origin was identified in 13 patients (16.5%). Other causes accounted for 12 cases (15.1%). Unknown etiology was reported in 15 cases (19%). The mean VWF content in the clots was 12.8%. According to the Mann-Whitney U-test, the level of VWF was significantly higher in the cases with unknown etiology compared to cardioembolic origin (p=0.044). We found also that patients with unknown etiology of stroke had higher VWF expression as compared to the other two subtypes, although this difference was not statistically significant. Conclusions: Among the patients with ischemic stroke included in this study, the VWF expression was significantly increased in those with unknown etiology compared to the group with cardioembolic stroke. Our finding provides new insights into clot composition in cryptogenic stroke and may influence the treatment and secondary prevention in these cases.

scholarly journals Thrombus Composition and Efficacy of Thrombolysis and Thrombectomy in Acute Ischemic Stroke

Stroke ◽  
2021 ◽  
Author(s):  
Precious Jolugbo ◽  
Robert A.S. Ariëns
Keyword(s):  
Ischemic Stroke ◽  
Blood Cell ◽  
Acute Ischemic Stroke ◽  
Red Blood Cell ◽  
Reference Lists ◽  
Mechanical Thrombectomy ◽  
Extracellular Traps ◽  
Von Willebrand ◽  
The Impact ◽  
Willebrand Factor

Thrombi retrieved from patients with acute ischemic stroke are highly heterogeneous. Recent data suggest that thrombus composition may impact on mechanical thrombectomy, the number of recanalization manoeuvres, resistance to retrieval, and on thrombolytic potential. Our aim was to summarize evidence describing the impact of thrombus composition on efficacy of mechanical thrombectomy and thrombolysis in patients with acute ischemic stroke. The scoping review methodology guided by the Joanna Briggs Institute, an adaption of the Arksey and O’Malley, was followed. Comprehensive searches were conducted in MEDLINE, EMBASE, SCOPUS, and Web of Science. Articles were classified into 4 key themes: (1) composition of stroke thrombi, (2) thrombus composition and mechanical thrombectomy, (3) thrombus composition and thrombolytic therapy, and (4) novel imaging and endovascular approaches. Our search identified 698 articles published from 1987 to June 2020. Additional articles were extracted from reference lists of the selected articles. Overall, 95 topic-specific articles identified for inclusion published in 40 different journals were included. Reports showed that thrombus composition in stroke was highly heterogeneous, containing fibrin, platelets, red blood cells, VWF (von Willebrand Factor), and neutrophil extracellular traps. Thrombi could roughly be divided into fibrin- and red blood cell–rich clots. Fibrin-rich clots were associated with increased recanalization manoeuvres, longer procedure time, and less favorable clinical outcomes compared with red blood cell–rich clots. Advances in detection or treatment of thrombi that take into account clot heterogeneity may be able to improve future endovascular and thrombolytic treatment of stroke.

Abstract TP440: Heart Failure is Associated With Elevated von Willebrand Factor (vWF) Antigen but not Factor VIII (FVIII) in Acute Ischemic Stroke (AIS)

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Alyana Samai ◽  
Karen Albright ◽  
Eleni Antzoulatos ◽  
Laurie Schluter ◽  
Sheryl Martin-Schild
Keyword(s):  
Heart Failure ◽  
Ischemic Stroke ◽  
Factor Viii ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Left Ventricular ◽  
Lv Function ◽  
Stroke Registry ◽  
Von Willebrand ◽  
Willebrand Factor

Introduction: von Willebrand Factor (vWF) and factor VIII (FVIII) contribute to thrombosis and are important risk factors in acute ischemic stroke (AIS). Elevated vWF has been correlated with depressed left ventricular (LV) function, but has not been examined in a cohort of patients with AIS, particularly with regard to concurrent elevation in FVIII. Hypothesis: We hypothesized that vWF is associated with HF and that combined elevation of vWF and FVIII would strengthen this association. Methods: From our prospective stroke registry, AIS patients >18 years of age admitted from 09/2011 to 01/2015 were included if both FVIII and vWF were measured during hospitalization and an echocardiogram was performed. Comparisons were done between the following groups: patients with normal (-) vs. elevated (+) vWF, patients with (-) vs. (+) FVIII, and patients with (-) vs. (+) levels of both factors. Results: Of 1,091 patients in the study period, 212 patients met inclusion criteria. In all groups, patients differed significantly according to history of DM. +vWF had higher frequency of female gender than -vWF, but did not differ according to any other demographic or baseline characteristics. +vWF patients had higher frequency of HF (p=0.007) and higher frequency of depressed LV function (p=0.028) compared to those with -vWF. vWF level correlated with HF (r=0.189, p=0.006) and reduced LV function (r=0.187, p=0.006). Similar findings were found with dual elevation, but we found no relationship between FVIII and HF. After adjustment for HTN, CAD, and DM, vWF remained an independent predictor of HF (OR 1.003, 95%CI 1.000-1.007, p=0.036). While we found no relationship between LV function and FVIII level, median vWF levels increased with decreasing LV function (p=0.027). Conclusion: The results of our study suggest an association between HF and elevated vWF in the setting of AIS, irrespective of FVIII elevation. These results suggest the potential utility of vWF as an independent biomarker for heart failure in the AIS patient population.

Sequential changes in von Willebrand factor and soluble thrombomodulin in acute ischemic stroke

2001 ◽  
Vol 10 (6) ◽  
pp. 257-264 ◽  
Author(s):  
Eiichi Nomura ◽  
Tatsuo Kohriyama ◽  
Kazuko Kozuka ◽  
Hiroshi Kajikawa ◽  
Shigenobu Nakamura
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Von Willebrand Factor ◽  
Soluble Thrombomodulin ◽  
Von Willebrand ◽  
Willebrand Factor
Sign in / Sign up

Export Citation Format

Share Document