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Red and White Thrombus Characteristics in Patients Undergoing Carotid Endarterectomy
Hatice Tosun1, Suat Kamışlı2, Mehmet Tecellioğlu2
1Fethi Sekin City Hospital, Elazığ, Turkey.
Insights
Red thrombi, more common in carotid endarterectomy patients, exhibit more unstable characteristics than white thrombi, indicating a higher risk for ischemic cerebrovascular events.
Area of Science:
- Vascular Surgery
- Neurology
- Pathology
Background:
- Carotid artery stenosis is a significant risk factor for ischemic stroke.
- Thrombus composition plays a crucial role in cerebrovascular events.
- Understanding thrombus characteristics can improve stroke risk stratification.
Purpose of the Study:
- To compare the pathological characteristics of red and white thrombi in patients with carotid artery stenosis.
- To determine if thrombus color correlates with plaque instability markers.
Main Methods:
- Analysis of thrombus samples from 81 patients undergoing carotid endarterectomy for ischemic stroke.
- Pathological assessment of plaque rupture, lipid core, fibrous cap, inflammation, hemorrhage, calcification, and neovascularization.
- Statistical comparison between red and white thrombus groups.
Main Results:
- Red thrombi constituted 80.2% of samples, compared to 19.8% for white thrombi.
- Red thrombi showed significantly higher rates of plaque rupture, lipid core, necrotic core, neovascularization, intraplaque hemorrhage, and inflammation.
- No significant differences were found in calcification or fibrous cap thickness between the two groups.
Conclusions:
- Red thrombi are associated with more unstable plaque characteristics compared to white thrombi.
- This suggests a potentially higher risk of ischemic cerebrovascular events with red thrombi.
- Further large-scale studies are needed to confirm these findings and their clinical implications.
Objective:
The study aimed to compare the characteristics of red and white thrombi in patients undergoing carotid endarterectomy.
Material And Methods:
The study was conducted in 81 patients with ischemic stroke who underwent carotid endarterectomy for carotid artery stenosis. Carotid plaques were graded by two pathologists. Thrombus materials were divided into two groups: white and red. The parameters of assessment were plaque rupture, lipid core, fibrous cap thickness, inflammation, intraplaque hemorrhage, calcification, necrotic core, and neovascularization. Normally distributed data were evaluated using Mann-Whitney U and Chi-squared tests.
Results:
The ratio of white and red thrombus was 19.8% and 80.2%, respectively. Lipid core, plaque rupture, necrotic core, neovascularization, intraplaque hemorrhage, obstruction, and inflammation were observed more in red thrombus, which were statistically significant. Calcification and fibrous cap thickness were not statistically significant in the two groups. Moreover, intimal smooth muscle cells were present in all thrombus types.
Conclusion:
In our study, we found that red thrombi had more unstable characteristics than white thrombi. Thus, the risk for ischemic cerebrovascular events is more in red thrombi. However, this finding cannot be generalized due to the small number of patients in this study. Therefore, studies involving more patients are needed.
