{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T22:58:29Z","timestamp":1780095509685,"version":"3.54.0"},"reference-count":27,"publisher":"BMJ","issue":"12","funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2019,4,9]]},"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Polymer coating embolism due to vascular medical device use is an increasingly recognized iatrogenic complication. This phenomenon has been linked with various adverse effects including neuroinflammation, acute ischemic stroke, cerebral hemorrhage, and death. Notably, procedure- and device-specific risks of this complication are poorly investigated. In this study, we evaluate the detectable frequency of intra-arterial polymer coating delamination among patients who underwent endovascular thrombectomy for treatment of acute ischemic stroke due to large vessel occlusion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Ninety-two cerebral thrombectomy specimens were retrospectively analyzed for the presence of polymer coating particulates. Histologic findings were correlated with demographic and procedural details and patient outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Evidence of polymer coating deposition was found in 30 of 92 extracted thrombi (33%). No correlation between intrathrombus polymer deposition and use of a specific thrombectomy device such as a stent retriever, aspiration catheter, or guide catheter was found. However, heterogeneous patterns of device use suggest a number of culprit devices. A trend toward longer procedure times and multiple thrombectomy passes was noted in positive cases. Intrathrombus polymer deposition was not associated with adverse clinical outcomes as measured by the 90-day modified Rankin Scale (mRS); however, small sample size and follow-up intervals limit interpretation. Ninety-day outcomes based on mRS may not fully capture the clinical effects of acute and\/or delayed intracerebral polymer complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In light of documented adverse neurologic effects, the frequency of intrathrombus polymer particulates indicates the need for consensus testing methods and large-scale long-term prospective clinical device trials, with inclusion of relevant endpoints to better assess biomaterial and device risks to patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2018-014684","type":"journal-article","created":{"date-parts":[[2019,5,18]],"date-time":"2019-05-18T17:25:11Z","timestamp":1558200311000},"page":"1191-1196","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Intrathrombus polymer coating deposition: a pilot study of 91 patients undergoing endovascular therapy for acute large vessel stroke. Part I: Histologic frequency"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2532-7435","authenticated-orcid":false,"given":"Rashi I","family":"Mehta","sequence":"first","affiliation":[{"name":"Department of Radiology, West Virginia University, Morgantown, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9864-4805","authenticated-orcid":false,"given":"Ansaar T","family":"Rai","sequence":"additional","affiliation":[{"name":"Department of Neurointerventional Radiology, West Virginia University, Morgantown, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey A","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Pathology, West Virginia University, Morgantown, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orestes E","family":"Solis","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4917-6907","authenticated-orcid":false,"given":"Rupal I","family":"Mehta","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York, USA"},{"name":"Department of Neuroscience, University of Rochester, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,18]]},"reference":[{"key":"2025092913284670000_11.12.1191.1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1706442","article-title":"Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct","volume":"378","author":"Nogueira","year":"2018","journal-title":"N Engl J Med"},{"key":"2025092913284670000_11.12.1191.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1713973"},{"key":"2025092913284670000_11.12.1191.3","unstructured":"US\u00a0Food and Drug Administration. Lubricious coating separation from intravascular medical devices fda safety communication. Silver Spring, Maryland: FDA, 2015."},{"key":"2025092913284670000_11.12.1191.4","doi-asserted-by":"crossref","unstructured":"Mehta RI , Mehta RI . Hydrophilic polymer embolism: implications for manufacturing, regulation, and postmarket surveillance of coated intravascular medical devices. J Patient Saf 2018 [Epub ahead of print 19 Mar 2019].doi:10.1097\/PTS.0000000000000473","DOI":"10.1097\/PTS.0000000000000473"},{"key":"2025092913284670000_11.12.1191.5","doi-asserted-by":"crossref","first-page":"e287","DOI":"10.1016\/j.amjmed.2017.01.032","article-title":"Hydrophilic polymer embolism: an update for physicians","volume":"130","author":"Mehta","year":"2017","journal-title":"Am J Med"},{"key":"2025092913284670000_11.12.1191.6","doi-asserted-by":"publisher","DOI":"10.3171\/2013.11.JNS131599"},{"key":"2025092913284670000_11.12.1191.7","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.001816"},{"key":"2025092913284670000_11.12.1191.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2014.09.011"},{"key":"2025092913284670000_11.12.1191.9","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.humpath.2014.11.022","article-title":"Hydrophilic polymer embolism: an underrecognized iatrogenic cause of ischemia, inflammation, and coagulopathy","volume":"46","author":"Mehta","year":"2015","journal-title":"Hum Pathol"},{"key":"2025092913284670000_11.12.1191.10","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.humpath.2016.01.018","article-title":"Polymer-induced central nervous system complications following vascular procedures: spectrum of iatrogenic injuries and review of outcomes","volume":"53","author":"Mehta","year":"2016","journal-title":"Hum Pathol"},{"key":"2025092913284670000_11.12.1191.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2009.04.027"},{"key":"2025092913284670000_11.12.1191.12","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2010.74"},{"key":"2025092913284670000_11.12.1191.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.09.039"},{"key":"2025092913284670000_11.12.1191.14","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004399"},{"key":"2025092913284670000_11.12.1191.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.06.018"},{"key":"2025092913284670000_11.12.1191.16","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.118.009005","article-title":"Cerebral protection during catheter ablation of ventricular tachycardia in patients with ischemic heart disease","volume":"7","author":"Heeger","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2025092913284670000_11.12.1191.17","first-page":"1886","article-title":"Foreign bodies in small arteries after use of an infusion microcatheter","volume":"18","author":"Barnwell","year":"1997","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025092913284670000_11.12.1191.18","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318165582a"},{"key":"2025092913284670000_11.12.1191.19","doi-asserted-by":"publisher","DOI":"10.1177\/1591019915609171"},{"key":"2025092913284670000_11.12.1191.20","first-page":"28","article-title":"Neurological changes with abnormal brain reactivity following coiling of cerebral aneurysm. 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Case series and review of the literature","volume":"58","author":"Shotar","year":"2016","journal-title":"Neuroradiology"},{"key":"2025092913284670000_11.12.1191.25","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2018-014189"},{"key":"2025092913284670000_11.12.1191.26","first-page":"159101991983076","article-title":"Cerebral foreign body reaction due to hydrophilic polymer embolization following aneurysm treatment by pipeline flow diversion device","volume":"28","author":"Geisbush","year":"2019","journal-title":"Interv Neuroradiol"},{"key":"2025092913284670000_11.12.1191.27","unstructured":"AAMI TIR42:2010. Evaluation of particulates associated with vascular medical devices. Arlington, Virginia: Association for the Advancement of Medical Instrumentation, 2010."}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2018-014684","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T20:28:56Z","timestamp":1759177736000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2018-014684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,18]]},"references-count":27,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2019,11,15]]},"published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1136\/neurintsurg-2018-014684"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2018-014684","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5,18]]}}}