The Relationship Between Mean Platelet Volume, Platelet Count, Platelet Lymphocyte Ratio, and Recanalization Success in First-pass Thrombectomy of Middle Cerebral Artery Occlusions

Nihat Şengeze; Semih Giray

doi:10.4274/tnd.2020.87405

Nihat Şengeze¹, Semih Giray²

¹Suleyman Demirel University Faculty of Medicine, Department of Neurology, Isparta, Turkey
²Gaziantep University Faculty of Medicine, Department of Neurology, Gaziantep, Turkey

Keywords: Mechanical thrombectomy, middle cerebral artery occlusion, mean platelet volume, platelet count, platelet-lymphocyte ratio, ischemic stroke

Abstract

Objective: Platelet activation plays an important role in the development of cerebral arterial occlusion. Mean platelet volume (MPV) and platelet count are reported to be good indicators of platelet activity. The aim of this study was to investigate the relationship between MPV, platelet count, and the plateletlymphocyte ratio with endovascular recanalisation success in acute middle cerebral artery (MCA) M1 occlusions.

Materials and Methods: Ninety-one patients with acute stroke with MCA M1 occlusions who were treated with endovascular mechanical thrombectomy between January 2015 and January 2019 were included in the study. Complete blood count, routine biochemical tests, erythrocyte sedimentation rate, clotting time, aPTT, and INR values of all patients were evaluated. The patients were separated into two groups, those who were recanalized successfully with at least thrombolysis in cerebral infarction score (TICI) 2b at the first pass, and those whose recanalisation procedure was unsuccessful with ≤TICI 2a.

Results: Among the 91 patients included in the study, 61.5% (n=56) were women. The mean age was 62.3±13.4 years. The median National Institute of Health stroke scale score was 16 (14-19), platelet count was 261.360±78.100/µL, and MPV was 10.2±0.96 fL. There were 48 (52.7%) patients in the poor recanalization (≤ TICI 2a) group and 43 (47.3%) in the successful recanalization (≥ TICI 2b) group after the first pass. There were no statistically significant differences between recanalization success and MPV values, platelet counts, and platelet-lymphocyte ratio (PLR) after the first pass (p values respectively; 0.37, 0.12, and 0.26).

Conclusion: Our study revealed that there was no statistical relationship between first-pass thrombectomy success of MCA M1 occlusions and MPV, platelet count, and PLR values. It is essential to investigate other factors beyond MPV, platelet count, and PLR value in the recanalization success of MCA M1 occlusions.