Mechanical thrombectomy (MT) is a highly efficient treatment in patients with acute ischemic stroke due to large vessel occlusion (LVO). However, in a relevant proportion of LVO, no sufficient recanalization can be achieved. The composition of cerebral thrombi is highly heterogeneous and may constitute a relevant factor for insufficient reperfusion. We hypothesized that circulating cytokines and growth factors involved in thromboinflammation and platelet activation may be associated with reperfusion status and thrombus composition in patients undergoing MT. An according biomarker panel was measured in plasma specimens taken prior to MT and at a 7-day follow-up. The reperfusion status was categorized into sufficient or insufficient. The composition of retrieved thrombi was histologically analyzed. Differences of baseline biomarker concentrations between insufficient and sufficient reperfusions were highest for interferon (IFN)-γ, epidermal growth factor, platelet-derived growth factor (PDGF)-AB/BB, and IFN-γ-induced protein 10 (IP-10/CXCL10). After applying correction for multiple comparisons and logistic regression analysis adjusting for stroke etiology, intravenous thrombolysis, and vascular risk factors, PDGF-AB/BB was identified as an independent predictor of reperfusion status (odds ratio: 0.403; 95% confidence interval: 0.199–0.819). Histological analysis revealed that the majority of thrombi had a mixed composition. In conclusion, this study provides the first evidence that cytokines and growth factors are potential effectors in patients undergoing MT for the treatment of acute ischemic stroke.

中文翻译：

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急性脑大血管闭塞中的循环细胞因子和生长因子——与血管内治疗成功的相关性

机械血栓切除术 (MT) 是大血管闭塞 (LVO) 引起的急性缺血性卒中患者的一种高效治疗方法。然而，在相关比例的 LVO 中，无法实现充分的再通。脑血栓的成分具有高度异质性，可能构成再灌注不足的相关因素。我们假设参与血栓炎症和血小板活化的循环细胞因子和生长因子可能与接受 MT 的患者的再灌注状态和血栓成分有关。在 MT 之前和 7 天随访时采集的血浆样本中测量了相应的生物标志物组。再灌注状态分为充分或不足。对取回的血栓的组成进行组织学分析。干扰素 (IFN)-γ、表皮生长因子、血小板衍生生长因子 (PDGF)-AB/BB 和 IFN-γ 诱导蛋白 10 (IP-10/IP-10/ CXCL10). 在对卒中病因学、静脉溶栓和血管危险因素进行多重比较校正和逻辑回归分析调整后，PDGF-AB/BB 被确定为再灌注状态的独立预测因子（比值比：0.403；95% 置信区间：0.199– 0.819）。组织学分析显示大部分血栓具有混合成分。总之，这项研究提供了第一个证据，表明细胞因子和生长因子是接受 MT 治疗急性缺血性中风的患者的潜在效应物。