Open AccessCorrelation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome
Author(s) -
Seán Fitzgerald,
Oana Madalina Mereuta,
Karen Doyle,
Daying Dai,
Ramanathan Kadirvel,
David F. Kallmes,
Waleed Brinjikji
Publication year - 2019
Publication title -
journal of neurosurgical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.525
H-Index - 35
eISSN - 1827-1855
pISSN - 0390-5616
DOI - 10.23736/s0390-5616.18.04629-5
Subject(s) - medicine , etiology , revascularization , stroke (engine) , acute stroke , cardiology , radiology , tissue plasminogen activator , mechanical engineering , myocardial infarction , engineering
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.