Histologic features of acute thrombi retrieved from stroke patients during mechanical reperfusion therapy

Abstract

Acute thrombi showed different histologic features according to the stroke etiology. The distribution of platelets and proportion of red blood cells and fibrin were major distinguishing factors between stroke subtypes.

Neutrophil extracellular traps in ischemic stroke thrombi

“…8,[11][12][13] Despite this variability, however, all stroke thrombi contained significant amounts of infiltrated leukocytes. Such heterogeneity is in line with previous studies.…”

“…2 The enormous clinical, economic, and social burden of ischemic stroke is in strong contrast with the limited treatment options that are available. [6][7][8][9][10][11][12][13] Recently, neutrophil extracellular traps (NETs) have been found to be implicated in thrombosis. Endovascular treatment is unfortunately not always available, and t-PA therapy is limited by the narrow therapeutic time window (4.5 hours after stroke onset) 3 .…”

“…First insights point toward a diverse thrombus composition, suggesting that many factors could influence thrombolysis success rates. [6][7][8][9][10][11][12][13] Recently, neutrophil extracellular traps (NETs) have been found to be implicated in thrombosis. 14,15 Initially discovered as a novel form of neutrophil-mediated immunity, NETs form through the release of decondensed chromatin that is lined with granular components, creating fibrous structures with antimicrobial properties.…”

Thrombectomy of calcified emboli in stroke. Does histology of thrombi influence the effectiveness of thrombectomy?

“…Based on histological analysis of thrombi retrieved from 36 acute stroke patients, artheriogenic emboli with a core rich in red blood cells (56.9%±12.2%) and peripherally located platelets, and cardiogenic emboli with fibrin as the predominant component (39.5%±13.5%), may be distinguished 7. Rarely, calcified thromboemboli causing a large vessel occlusion are encountered.…”

Prediction of the Multisegment Clot Sign on Dynamic CT Angiography of Cardioembolic Stroke

“…A previous histologic study found that the features of the clots in patients with undetermined etiology were like those of cardiogenic thrombi. 25 Therefore, the presence of the MSC sign in patients with acute ischemic stroke with inexplicit etiology during this hospitalization indicates the importance of the search for the cardiac sources. Anticoagulation is highly effective for reduction of recurrent stroke among patients with atrial fibrillation.…”