Water content for clot composition prediction in acute ischemic stroke

Area of Science:

• Biomedical Engineering
• Neuroscience
• Radiology

Background:

• Mechanical thrombectomy (MT) is standard for acute ischemic stroke (AIS) from large vessel occlusion.
• Accurate clot composition assessment is crucial for optimizing neuroendovascular techniques.
• Current imaging lacks reliable clot composition discrimination; water content may offer indirect insights.

Purpose of the Study:

• To investigate the correlation between water content and clot composition.
• To assess if water content can serve as a surrogate marker for clot constituents.

Main Methods:

• Analyzed ten human AIS clots from MT procedures.
• Created and analyzed ten ovine red blood cell (RBC)-rich and ten fibrin-rich clots.
• Evaluated clot water content and composition under simulated intracranial flow conditions.
• Performed linear regression to establish relationships between water content and clot components.

Main Results:

• Human stroke clots showed a significant negative correlation between RBC concentration and water content.
• Ovine clots demonstrated a positive correlation between water content and both fibrin and platelet concentrations.

Conclusions:

• Clot water content is significantly associated with its composition (RBCs, fibrin, platelets).
• Water content may serve as an indirect imaging biomarker for predicting clot composition in AIS.
• This finding could inform personalized treatment strategies for mechanical thrombectomy.