Akut iskemik inmede intravenöz trombolitik ve mekanik trombektomi tedavileri sonucu reperfüzyon yanıtının belirlenmesinde biyokimyasal ve nörobiyolojik yanıtların araştırılması

In this study, it was aimed to investigate the roles of MMP-9, MMP-2, VE-cadherin, N-cadherin, β2 integrin, S1PR2 and PDGFR-β in neuroinflammation and reperfusion after iv tPA and mechanical thrombectomy. In addition, thrombi removed by mechanical thrombectomy were examined to understand the underlying mechanisms of reperfusion. 101 patients admitted with acute ischemic stroke were examined in three groups as those who underwent iv tPA, mechanical thrombectomy and bridging therapy. Detailed clinical information was recorded. Infarct and hemorrhage volumes were calculated from cranial imaging performed at 24 hours. Blood samples were taken from the patients before and 24 hours after treatment, and the levels of MMP-9, MMP-2, VE-cadherin, N-cadherin, β2 integrin, S1PR2 and PDGFR-β were studied by ELISA. Thrombi were stained with hematoxylin-eosin and Martius Scarlet Blue for the analysis of fibrin and erythrocyte contents, and CD34 for determining endothelium in thrombus. PDGFR-β levels were low in patients with smaller infarct and hemorrhage volume. S1PR2 levels were related with large artery atherosclerosis. From 56 thrombi, 41 were fibrin-dominant, 15 were RBC-dominant. Fibrin content was higher in thrombi removed with stent-retriever and combined methods. A significant relationship was found between RBC dominance and hyperdense artery sign. More CD34-stained areas were found in patients with longer symptom-recanalization time and thrombi removed from distal branches. In conclusion, PDGFR-β and S1PR2 may be associated with ischemia-reperfusion injury and intracranial hemorrhage after acute ischemic stroke. Future studies on immunological examination of the thrombus may provide further insights.