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 在过去的四年里，我们的研究小组从美国和加拿大的中心收集了超过1800例中风栓塞， 脑卒中血栓栓塞影像学和病理学登记处（STRIP）。STRIP注册表是我们的 目前R01奖的目标1，是非常富有成效的。我们已经进一步阐明了血栓与 组织学和血运重建结果，以及凝块组织学和成像特征。条带 登记研究还使我们能够发现卒中血栓形成的新机制，催化血栓切除术 设备研究和溶栓相关研究。 我们认为，我们登记研究中最有影响力的发现将是揭示以下方面的关联： 取出栓子的组织病理学和卒中病因学。开发预测中风病因的工具很重要 因为将近40%的中风病因不明确定卒中病因（即心源性与 大动脉粥样硬化）是重要的，因为二级卒中预防策略高度依赖于 中风病因的确定。然而，当我们进行表面的定量分析时， 纤维蛋白、血小板、白细胞和红细胞密度之间的关系，我们的结果没有揭示。但我们 假设基于对取出的卒中栓子的分析来预测卒中病因仍然是可行的 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 还有助于揭示与设备相关的组织学特征以及与中风相关的药理学失败 血运重建 因此，这份行政补充文件的目标是：1）允许我们的 超过1800个检索到的凝块样本的数据库以及来自Aim 1的所有可用匿名临床数据， 我们目前的R01，以促进深度学习和机器学习，2）在整体上进行深度学习 从这些患者身上提取样本，以确定各种深度学习和机器学习算法是否可以 仅根据取出的卒中栓子的组织学外观，用于预测卒中病因。

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

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

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