Immune System Activation in Perioperative Thrombectomy Patients: Preliminary Retrospective Study

World Neurosurg. 2019 Aug:128:e966-e969. doi: 10.1016/j.wneu.2019.05.044. Epub 2019 May 14.

Abstract

Background: Ischemic stroke is a devastating condition resulting in significant morbidity. Mechanical thrombectomy is now standard for large vessel occlusive stroke. Neuroinflammation is known to play important roles in ischemic stroke. Our aims were to examine our thrombectomy procedures and preliminarily examine systemic immune response in relation to thrombectomy changes.

Methods: A retrospective review was conducted on mechanical thrombectomy cases from July 2011 through December 2015. Primary outcomes were time to recanalization, final Thrombolysis in Cerebral Infarction score, procedural complications, National Institutes of Health Stroke Scale improvement, and changes in white blood cell (WBC) count.

Results: One-hundred and twenty-nine procedures were performed. We found a significant difference between WBC count on admission and WBC count post thrombectomy day 1 for patients with >90 minutes to recanalization (P = 0.006107). There was a positive association between WBC change and absolute National Institutes of Health Stroke Scale change among females (P = 0.0273) but not among males.

Conclusions: Overall, we found that systemic immune response has close relationships with speed of recanalization and preliminarily may shift differently on the basis of sex.

Keywords: Immune activation; Mechanical thrombectomy; Sex differences; White blood cells.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Ischemia / surgery
  • Female
  • Humans
  • Immune System*
  • Leukocyte Count
  • Male
  • Middle Aged
  • Perioperative Period
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Sex Characteristics
  • Stroke / etiology
  • Stroke / surgery
  • Thrombectomy / methods*
  • Treatment Outcome
  • Young Adult