REVIEW   

Journal of Neurosurgical Sciences 2019 June;63(3):292-300

DOI: 10.23736/S0390-5616.18.04629-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome

Seán FITZGERALD ^{1, 2}, Oana M. MEREUTA ², Karen M. DOYLE ², Daying DAI ¹, Ramanathan KADIRVEL ¹, David F. KALLMES ^{1, 3}, Waleed BRINJIKJI ^{1, 3} ✉

¹ Department of Radiology, Mayo Clinic, Rochester, MN, USA; ² CÚRAM-Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland; ³ Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA

Mechanical thrombectomy has become the stand of care for patients with large vessel occlusions, yet major improvements in thrombectomy speed, efficacy, and completeness can still be achieved. High rates of clot fragmentation and failure to remove the clot resulting in poor neurological outcomes suggest that in order to further advance the field of stroke intervention we must turn our attention towards understanding the science of clot. Accurately identifying the composition of the occlusive clot prior to intervention could significantly influence the success of the revascularization strategy used to treat them. Numerous features of thromboemboli could be studied and characterized, including quantitative histomorphometry and diagnostic imaging characteristics. Each of these features might logically predict superior thrombectomy outcomes with one device or another. This article aims to review the current literature on histopathological composition of acute ischemic stroke clots, with a particular focus on the correlation between clot composition and diagnostic imaging, stroke etiology and revascularization outcomes.

KEY WORDS: Stroke - Thrombosis - Immunohistochemistry - Thrombectomy