Histopathologic findings of vascular damage after mechanical thrombectomy using stent retriever in canine models.

Abstract

Although mechanical thrombectomy is a powerful predictor of stroke outcome, it induces vessel wall injury in the acute phase. This study aimed to analyze the degree and the condition of recovery of wall injury after the acute phase via angiography and histopathological analysis of autopsied canine models. Digital subtraction angiography (DSA) and embolization with autologous thrombus were performed in six canines. The model of arterial occlusion was effective in all target vessels. Mechanical thrombectomy was performed in completely occluded vessels using stent retriever. Follow-up angiographic and histopathologic evaluations were performed 1 month later. Complete recanalization using stent retriever was achieved in four cases. Slight residual vessel narrowing after recanalization and moderate narrowing was observed in one case each. Histopathological analysis showed that inflammation, hemorrhage, and device-induced medial injury were not observed in any of the cases. Severe intimal proliferation (grade 4), marked diffuse thrombosis (grade 4), and weak vascular endothelial cell loss (grade 1) were observed in one case and weak endovascular proliferation was observed in one case. Although successful complete recanalization was achieved with a single mechanical thrombectomy attempt and no change was observed in the follow-up DSA, special attention should be paid to postoperative follow-up, as device-induced intimal proliferation, diffuse thrombosis, and endothelial cell loss may remain after 1 month.