title: Immunohistochemical Analysis of Cerebral Thrombi Retrieved by Mechanical Thrombectomy from Patients with Acute Ischemic Stroke.
abstract: Mechanical thrombectomy is a novel treatment option for patients with acute ischemic stroke (AIS). Only a few studies have previously suggested strategies to categorize retrieved clots according to their histologic composition. However, these reports did not analyze potential biomarkers that are of importance in stroke-related inflammation. We therefore histopathologically investigated 37 intracerebral thrombi mechanically retrieved from patients with AIS, and focused on the composition of immune cells and platelets. We also conducted correlation analyses of distinctive morphologic patterns (erythrocytic, serpentine, layered, red, white, mixed appearance) with clinical parameters. Most T cells and monocytes were detected in erythrocytic and red clots, in which the distribution of these cells was random. In contrast, von Willebrand factor (vWF)-positive areas co-localized with regions of fibrin and collagen. While clots with huge amounts of vWF seem to be associated with a high National Institute of Health Stroke Scale score at admission, histologic findings could not predict the clinical outcome at discharge. In summary, we provide the first histologic description of mechanically retrieved intracerebral thrombi regarding biomarkers relevant for inflammation in ischemic stroke.
authors.affiliation: Department of Neurology, University Hospital Würzburg, 97080 Würzburg, Germany. schuhmann_m@ukw.de.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Schuhmann
authors.affiliation: Department of Neurology, University Hospital Würzburg, 97080 Würzburg, Germany. Gunreben_i@ukw.de.
authors.forename: Ignaz
authors.initials: I
authors.lastname: Gunreben
authors.affiliation: Department of Neurology, University Hospital Würzburg, 97080 Würzburg, Germany. kleinschni_c@ukw.de.
authors.forename: Christoph
authors.initials: C
authors.lastname: Kleinschnitz
authors.affiliation: Department of Neurology, University Hospital Würzburg, 97080 Würzburg, Germany. kraft_p1@ukw.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Kraft
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002545:Brain Ischemia / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D005337:Fibrin / Q000378:metabolism; D006801:Humans; D008214:Lymphocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D017131:Thrombectomy; D013927:Thrombosis / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D005337:Fibrin
keywords: immune cells; inflammation; ischemic stroke; lymphocytes; mechanical thrombectomy; thrombus formation