Thrombus histology does not predict stroke etiological subtype but influences recanalization

Area of Science:

• Neurology
• Interventional Neuroradiology
• Pathology

Background:

• Conflicting data exists regarding the predictive value of mechanical thrombectomy clot composition for stroke etiology and recanalization success.
• Understanding thrombus histology is crucial for optimizing acute ischemic stroke treatment.

Purpose of the Study:

• To analyze the relationship between thrombus histology and stroke etiology.
• To investigate the correlation between clot composition and recanalization success in mechanical thrombectomy.

Main Methods:

• Histopathological analysis of retrieved clots from patients with acute ischemic stroke and large vessel occlusion.
• Quantification of fibrin, red blood cells (RBC), platelets, and white blood cells (WBC) within clots.
• Correlation analysis of clot composition with clinical data, imaging, and recanalization parameters.

Main Results:

• No significant correlation was found between clot composition (RBC-rich, platelet-rich, fibrin-rich) and stroke etiology.
• Red blood cell-rich clots were associated with the susceptibility vessel sign (92.3%) and 100% good recanalization.
• Platelet-rich and white blood cell-rich clots were independently associated with reduced recanalization time and fewer passes, respectively.

Conclusions:

• Thrombus histology does not predict the etiological subtype of stroke.
• Clot composition is a significant predictor of recanalization success and procedural efficiency in mechanical thrombectomy.