Impact of Clot Histological and Physical Properties on Revascularization Strategies in Acute Ischaemic Stroke - Administrative Supplement

血栓组织学和物理特性对急性缺血性中风血运重建策略的影响 - 行政补充

• 批准号: 10410193
• 负责人: Waleed Brinjikji
• 金额: $ 31.59万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2022-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10410193
• 关键词: Acute; Address; Administrative Supplement; Affect; Algorithms; Anticoagulation; Appearance; Architecture; Arteries; Atherosclerosis; Atrial Fibrillation; Award; Biological; Biological Markers; Blood Platelets; Canada; Cardiac; Cause of Death; Characteristics; Clinical; Clinical Data; Coagulation Process; DNA; Data; Data Set; Databases; Deep Vein Thrombosis; Device or Instrument Development; Devices; Embolism; Etiology; Failure; Fibrin; Goals; Histologic; Histology; Histopathology; Image; Ischemic Stroke; Knowledge; Left atrial structure; Machine Learning; Mechanics; Outcome; Pathology; Patients; Pharmacology; Play; Prevention strategy; Procedures; Public Health; Registries; Research; Research Personnel; Research Project Grants; Resolution; Role; Sampling; Scanning; Scientist; Secondary to; Slide; Source; Specimen; Stains; Stroke; Stroke prevention; Structure; Techniques; Testing; Therapeutic Embolization; Thrombectomy; Thromboembolism; Thrombosis; Translations; United States; Variant; Work; acute care; aortic arch; atherosclerotic plaque rupture; base; biobank; clinical practice; clinically significant; deep learning; deep learning algorithm; density; extracellular; grasp; histological specimens; imaging biomarker; improved; insight; machine learning algorithm; neutrophil; novel; online repository; organizational structure; physical property; programs; shear stress; standard of care; stroke patient; thrombolysis; tool; von Willebrand Factor

PROJECT SUMMARY In the last four years, our group collected >1800 stroke emboli from centers across the US and Canada as part of the Stroke Thromboembolism Registry of Imaging and Pathology (STRIP). The STRIP registry was our current R01 award’s Aim 1 and is very fruitful. We have further elucidated the association between clot histology and revascularization outcomes, as well as clot histology and imaging characteristics. The STRIP registry has also allowed us to uncover novel mechanisms in stroke thrombosis, catalyzing thrombectomy device research and thrombolysis related research in our lab. We believe that the most impactful finding from our registry will be uncovering associations between histopathology of retrieved emboli and stroke etiology. Developing tools to predict stroke etiology is important because nearly 40% of strokes are of unknown etiology. Determine stroke etiology (i.e. cardiac source versus large artery atherosclerosis) is important as secondary stroke prevention strategies are highly dependent on determination of stroke etiology. However, when we performed superficial quantitative analyses examining the relationships between fibrin, platelet, WBC and RBC density, our results were unrevealing. Still, we hypothesize that it remains feasible to predict stroke etiology based of analysis of retrieved stroke emboli through deep learning and machine learning approaches. Machine learning and deep learning approaches can also aid in uncovering histological features associated with device and pharmacological failure related to stroke revascularization. Thus, this administrative supplement’s goal of is to 1) allow for complete digitization and online archiving of our database of over 1800 retrieved clot specimens as well as all available anonymized clinical data from Aim 1 of our current R01 to facilitate deep learning and machine learning and 2) to perform deep learning on the whole slide specimens from these patients to determine if various deep learning and machine learning algorithms can be used to predict stroke etiology based solely off of the histological appearance of retrieved stroke emboli.

项目摘要 在过去的四年中，我们的小组从美国和加拿大的中心收集了> 1800个中风栓塞 成像和病理学的中风血栓症注册表（条带）。脱衣舞注册表是我们的 当前R01奖的AIM 1，非常富有成果。我们进一步阐明了克隆之间的关联 组织学和血运重建结果以及凝块组织学和成像特征。条纹 注册中心还允许我们发现中风血栓形成，催化血栓切除术的新机制 设备研究和溶栓相关研究。 我们认为，注册表中最有影响力的发现将是揭示 检索栓子和中风病因的组织病理学。开发预测中风病因的工具很重要 因为将近40％的中风是未知的病因。确定中风病因（即心脏来源与 大动脉粥样硬化）很重要，因为预防次级中风策略高度依赖 中风病因的确定。但是，当我们进行了表面定量分析时 纤维蛋白，血小板，WBC和RBC密度之间的关系，我们的结果没有透视。不过，我们 假设基于检索的中风栓塞分析预测中风病因是仍然可行的 通过深度学习和机器学习方法。机器学习和深度学习方法可以 还有助于发现与设备相关的组织学特征和与中风有关的药物特征 血运重建。 这就是行政补充的目标是1）允许我们的数字化和在线归档我们 超过1800的数据库检索了凝块标本以及所有可用的匿名临床数据 我们目前的R01促进深度学习和机器学习以及2）整体进行深度学习 来自这些患者的幻灯片标本，以确定各种深度学习和机器学习算法是否可以 仅根据检索到的中风栓塞的组织学外观来预测中风病因。

项目成果

Shell Versus Core Architecture and Biology of Thrombi in Acute Ischemic Stroke: A Systematic Review.

• DOI: 10.1177/10760296231213632
• 发表时间: 2023-01
• 期刊: CLINICAL AND APPLIED THROMBOSIS-HEMOSTASIS
• 影响因子: 2.9
• 作者: Mereuta, Oana Madalina;Agarwal, Tamanna;Ghozy, Sherief;Dai, Daying;Arul, Santhosh;Brinjikji, Waleed;Kallmes, David F.;Kadirvel, Ram
• 通讯作者: Kadirvel, Ram

Correlation of Neutrophil to Lymphocyte Ratio with Expression of Neutrophil Extracellular Traps Within Stroke Emboli.

中性粒细胞与淋巴细胞比率与中风栓塞内中性粒细胞胞外陷阱表达的相关性。

• DOI: 10.1177/15910199211065530
• 发表时间: 2022
• 期刊: Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
• 作者: Larco,JorgeArturo;Abbasi,Mehdi;Madhani,SaroshIrfan;Mereuta,MadalinaOana;Liu,Yang;Dai,Daying;Kadirvel,Ramanathan;Savastano,Luis;Kallmes,DavidF;Brinjikji,Waleed
• 通讯作者: Brinjikji,Waleed

Systematic review and meta-analysis of current rates of first pass effect by thrombectomy technique and associations with clinical outcomes.

• DOI: 10.1136/neurintsurg-2020-016869
• 发表时间: 2021-03
• 期刊: Journal of neurointerventional surgery
• 影响因子: 4.8

Intra-procedural cerebral sinus thrombosis during endovascular treatment of idiopathic intracranial hypertension.

特发性颅内高压血管内治疗期间术中脑窦血栓形成。

• DOI: 10.1177/19714009221096837
• 发表时间: 2022
• 期刊: The neuroradiology journal
• 作者: Larco,JorgeArturo;Abbasi,Mehdi;Kadirvel,Ramanathan;Kallmes,DavidF;Savastano,LuisE;Brinjikji,Waleed
• 通讯作者: Brinjikji,Waleed

Preclinical testing platforms for mechanical thrombectomy in stroke: a review on phantoms, in-vivo animal, and cadaveric models.

• DOI: 10.1136/neurintsurg-2020-017133
• 发表时间: 2021-09
• 期刊: Journal of neurointerventional surgery
• 影响因子: 4.8
• 作者: Liu Y;Abbasi M;Arturo Larco JL;Kadirvel R;Kallmes DF;Brinjikji W;Savastano L
• 通讯作者: Savastano L