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Published on: September 17, 2014
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Clot Histopathology in Ischemic Stroke with Infective Endocarditis
Sonu Bhaskar1, Jawad Saab2, Cecilia Cappelen-Smith1
1Department of Neurology & Neurophysiology,Liverpool Hospital,Sydney, NSW,Australia.
Summary
Histopathological analysis of clots retrieved via endovascular thrombectomy (EVT) in acute ischemic stroke (AIS) patients with infective endocarditis (IE) revealed specific bacterial morphology. This finding aids in diagnosing IE-related strokes and informs treatment strategies.
Area of Science:
- Neurology
- Cardiology
- Pathology
Background:
- Endovascular thrombectomy (EVT) is effective for acute ischemic stroke (AIS) in patients with infective endocarditis (IE).
- Histopathological analysis of retrieved clots offers a novel method for determining stroke etiology, particularly for cryptogenic strokes.
- This study examines four consecutive AIS patients with IE who underwent EVT.
Purpose of the Study:
- To investigate the histopathological characteristics of clots retrieved by EVT in AIS patients with IE.
- To explore the potential of clot analysis in identifying IE as the stroke source.
- To assess the clinical value of understanding clot composition for diagnosis and treatment planning.
Main Methods:
- Comprehensive histopathological analysis of clots retrieved via EVT.
- Morphological examination and Gram staining of clot samples.
Main Results:
- Consistent findings included dense, paucicellular fibrinoid material with clusters of bacterial cocci.
- This specific clot morphology may indicate septic emboli from IE, differentiating it from incidental bacteremia.
- The observed morphology might explain the resistance of these clots to systemic thrombolysis.
Conclusions:
- Morphological and histopathological analysis of EVT-retrieved clots, including Gram staining, aids in etiological classification.
- Understanding clot composition is clinically valuable for early diagnosis and treatment planning in IE patients with stroke.
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