{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:36:20Z","timestamp":1788910580312,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2008,12]]},"abstract":"\n \n Background and Purpose\u2014<\/jats:italic>\n <\/jats:bold>\n Studies have established a relation between recanalization and improved clinical outcome in acute ischemic stroke patients; however, intra-arterial clot size has not been routinely assessed. The aim of the study was to determine the impact of intra-arterial thrombus burden on intra-arterial treatment (IAT) and clinical outcome.\n <\/jats:p>\n \n \n Methods\u2014<\/jats:italic>\n <\/jats:bold>\n A retrospective review of our IAT stroke database included procedure time, recanalization, symptomatic intracranial hemorrhage, poor outcome (modified Rankin Scale score \u22654 at discharge), and mortality. The modified Thrombolysis in Myocardial Infarction thrombus grade was dichotomized into grades 0 to 3 (no clot or moderate thrombus, <2 vessel diameters) versus grade 4 (large thrombus, >2 vessel diameters).\n <\/jats:p>\n \n \n Results\u2014<\/jats:italic>\n <\/jats:bold>\n Data were collected on 135 patients with thrombus grading. The baseline median National Institutes of Health Stroke Scale score was higher in patients of grade 4 compared with grades 0 to 3 (19 vs 17,\n P<\/jats:italic>\n =0.012). Grade 4 thrombi required longer (median, range) times for IAT (113, 37 to 415 minutes vs 74, 22 to 215 minutes, respectively;\n P<\/jats:italic>\n <0.001) and higher rates of mechanical clot disruption (wire, angioplasty, snare, stent, or Merci retriever) compared with grades 0 to 3 (76% vs 53%,\n P<\/jats:italic>\n =0.005). There were no differences in rates of symptomatic intracranial hemorrhage (6.6% vs 4.1%,\n P<\/jats:italic>\n =0.701) or recanalization (50% vs 61%,\n P<\/jats:italic>\n =0.216) in grade 4 versus grades 0 to 3. Multivariate analysis adjusted for age, baseline National Institutes of Health Stroke Scale score, and artery of involvement showed that grade 4 thrombi were independently associated with poor outcome (odds ratio=2.4; 95% CI, 1.06 to 5.57;\n P<\/jats:italic>\n =0.036) and mortality (odds ratio=4.0; 95% CI, 1.2 to 13.2;\n P<\/jats:italic>\n =0.023).\n <\/jats:p>\n \n \n Conclusions\u2014<\/jats:italic>\n <\/jats:bold>\n High thrombus grade as measured by the modified Thrombolysis in Myocardial Infarction criteria may be a risk factor that contributes to poor clinical outcome.\n <\/jats:p>","DOI":"10.1161\/strokeaha.108.521054","type":"journal-article","created":{"date-parts":[[2008,9,5]],"date-time":"2008-09-05T01:55:47Z","timestamp":1220579747000},"page":"3231-3235","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Thrombus Burden Is Associated With Clinical Outcome After Intra-Arterial Therapy for Acute Ischemic Stroke"],"prefix":"10.1161","volume":"39","author":[{"given":"Andrew D.","family":"Barreto","sequence":"first","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen C.","family":"Albright","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hen","family":"Hallevi","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Grotta","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Noser","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aslam M.","family":"Khaja","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashem M.","family":"Shaltoni","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole R.","family":"Gonzales","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kachi","family":"Illoh","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheryl","family":"Martin-Schild","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Morgan S.","family":"Campbell","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond U.","family":"Weir","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean I.","family":"Savitz","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (A.D.B., H.H., J.C.G., E.A.N., N.R.G., K.I., S.M.-S., M.S.C. III, S.I.S.), Stroke Division, University of Texas at Houston Medical School; Department of Neurosciences (K.C.A.), University of California at San Diego; Department of Neurology (A.M.K.), University of Illinois at Chicago Medical School; Department of Radiology (H.M.S.), Baylor University School of Medicine, Houston, Tex; and Department of Radiology (R.U.W.), University of Texas at Houston Medical School."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000260187.33864.a7"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.21.2003"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000147718.12954.60"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000055940.00316.6b"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000251800.01964.f6"},{"key":"e_1_3_2_6_2","first-page":"1177","volume":"27","year":"2006","unstructured":"Smith WS. 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Last accessed on March 20 2008."},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20976"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.108.521054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T12:14:55Z","timestamp":1715602495000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.108.521054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,12]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2008,12]]}},"alternative-id":["10.1161\/STROKEAHA.108.521054"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.108.521054","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,12]]},"assertion":[{"value":"2008-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2008-05-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2008-09-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}