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Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus?

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Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus? / Sporns, Peter B; Hanning, Uta; Schwindt, Wolfram; Velasco, Aglaé; Minnerup, Jens; Zoubi, Tarek; Heindel, Walter; Jeibmann, Astrid; Niederstadt, Thomas Ulrich.

in: STROKE, Jahrgang 48, Nr. 8, 08.2017, S. 2206-2210.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Sporns, PB, Hanning, U, Schwindt, W, Velasco, A, Minnerup, J, Zoubi, T, Heindel, W, Jeibmann, A & Niederstadt, TU 2017, 'Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus?', STROKE, Jg. 48, Nr. 8, S. 2206-2210. https://doi.org/10.1161/STROKEAHA.117.016590

APA

Sporns, P. B., Hanning, U., Schwindt, W., Velasco, A., Minnerup, J., Zoubi, T., Heindel, W., Jeibmann, A., & Niederstadt, T. U. (2017). Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus? STROKE, 48(8), 2206-2210. https://doi.org/10.1161/STROKEAHA.117.016590

Vancouver

Sporns PB, Hanning U, Schwindt W, Velasco A, Minnerup J, Zoubi T et al. Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus? STROKE. 2017 Aug;48(8):2206-2210. https://doi.org/10.1161/STROKEAHA.117.016590

Bibtex

@article{7450092630d546f88bac8f925ecf3568,
title = "Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus?",
abstract = "BACKGROUND AND PURPOSE: The introduction of stent retrievers allows for a complete extraction and histological analysis of human thrombi. Ischemic stroke is a major health issue, and differentiation of underlying causes is highly relevant to prevent recurrent stroke. Therefore, histopathologic analysis of the embolic clots after removal may provide valuable information about underlying pathologies. This study analyzes histological clot composition and aims to identify specific patterns that might help to distinguish causes of ischemic stroke.METHODS: Patients with occlusion of the carotid-T or middle cerebral artery who underwent thrombectomy at our university medical center between December 2013 and February 2016 were included. Samples were histologically analyzed (hematoxylin and eosin, Elastica van Gieson, and Prussian blue), additionally immunohistochemistry for CD3, CD20, and CD68/KiM1P was performed. These data, along with additional clinical and interventional parameters, were compared for different stroke subtypes, as defined by the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.RESULTS: One hundred eighty-seven patients were included, of these, in 77 patients, cardioembolic; in 46 patients, noncardioembolic; and in 64 patients, cryptogenic pathogenesis was determined. Cardioembolic thrombi had higher proportions of fibrin/platelets (P=0.027), less erythrocytes (P=0.005), and more leucocytes (P=0.026) than noncardioembolic thrombi. We observed a strong overlap of cryptogenic strokes and cardioembolic strokes concerning thrombus histology. The immunohistochemical parameters CD3, CD20, and CD68/KiM1P showed no statistically noticeable differences between stroke subtypes.CONCLUSIONS: Histological thrombus features vary significantly according to the underlying cause and may help to differentiate between cardioembolic and noncardioembolic stroke. In addition, our study supports the hypothesis that most cryptogenic strokes have a cardioembolic cause.",
keywords = "Aged, Aged, 80 and over, Brain Ischemia, Cohort Studies, Female, Humans, Male, Middle Aged, Prospective Studies, Retrospective Studies, Risk Factors, Stroke, Thrombectomy, Thrombosis, Journal Article",
author = "Sporns, {Peter B} and Uta Hanning and Wolfram Schwindt and Agla{\'e} Velasco and Jens Minnerup and Tarek Zoubi and Walter Heindel and Astrid Jeibmann and Niederstadt, {Thomas Ulrich}",
note = "{\textcopyright} 2017 American Heart Association, Inc.",
year = "2017",
month = aug,
doi = "10.1161/STROKEAHA.117.016590",
language = "English",
volume = "48",
pages = "2206--2210",
journal = "STROKE",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

RIS

TY - JOUR

T1 - Ischemic Stroke: What Does the Histological Composition Tell Us About the Origin of the Thrombus?

AU - Sporns, Peter B

AU - Hanning, Uta

AU - Schwindt, Wolfram

AU - Velasco, Aglaé

AU - Minnerup, Jens

AU - Zoubi, Tarek

AU - Heindel, Walter

AU - Jeibmann, Astrid

AU - Niederstadt, Thomas Ulrich

N1 - © 2017 American Heart Association, Inc.

PY - 2017/8

Y1 - 2017/8

N2 - BACKGROUND AND PURPOSE: The introduction of stent retrievers allows for a complete extraction and histological analysis of human thrombi. Ischemic stroke is a major health issue, and differentiation of underlying causes is highly relevant to prevent recurrent stroke. Therefore, histopathologic analysis of the embolic clots after removal may provide valuable information about underlying pathologies. This study analyzes histological clot composition and aims to identify specific patterns that might help to distinguish causes of ischemic stroke.METHODS: Patients with occlusion of the carotid-T or middle cerebral artery who underwent thrombectomy at our university medical center between December 2013 and February 2016 were included. Samples were histologically analyzed (hematoxylin and eosin, Elastica van Gieson, and Prussian blue), additionally immunohistochemistry for CD3, CD20, and CD68/KiM1P was performed. These data, along with additional clinical and interventional parameters, were compared for different stroke subtypes, as defined by the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.RESULTS: One hundred eighty-seven patients were included, of these, in 77 patients, cardioembolic; in 46 patients, noncardioembolic; and in 64 patients, cryptogenic pathogenesis was determined. Cardioembolic thrombi had higher proportions of fibrin/platelets (P=0.027), less erythrocytes (P=0.005), and more leucocytes (P=0.026) than noncardioembolic thrombi. We observed a strong overlap of cryptogenic strokes and cardioembolic strokes concerning thrombus histology. The immunohistochemical parameters CD3, CD20, and CD68/KiM1P showed no statistically noticeable differences between stroke subtypes.CONCLUSIONS: Histological thrombus features vary significantly according to the underlying cause and may help to differentiate between cardioembolic and noncardioembolic stroke. In addition, our study supports the hypothesis that most cryptogenic strokes have a cardioembolic cause.

AB - BACKGROUND AND PURPOSE: The introduction of stent retrievers allows for a complete extraction and histological analysis of human thrombi. Ischemic stroke is a major health issue, and differentiation of underlying causes is highly relevant to prevent recurrent stroke. Therefore, histopathologic analysis of the embolic clots after removal may provide valuable information about underlying pathologies. This study analyzes histological clot composition and aims to identify specific patterns that might help to distinguish causes of ischemic stroke.METHODS: Patients with occlusion of the carotid-T or middle cerebral artery who underwent thrombectomy at our university medical center between December 2013 and February 2016 were included. Samples were histologically analyzed (hematoxylin and eosin, Elastica van Gieson, and Prussian blue), additionally immunohistochemistry for CD3, CD20, and CD68/KiM1P was performed. These data, along with additional clinical and interventional parameters, were compared for different stroke subtypes, as defined by the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.RESULTS: One hundred eighty-seven patients were included, of these, in 77 patients, cardioembolic; in 46 patients, noncardioembolic; and in 64 patients, cryptogenic pathogenesis was determined. Cardioembolic thrombi had higher proportions of fibrin/platelets (P=0.027), less erythrocytes (P=0.005), and more leucocytes (P=0.026) than noncardioembolic thrombi. We observed a strong overlap of cryptogenic strokes and cardioembolic strokes concerning thrombus histology. The immunohistochemical parameters CD3, CD20, and CD68/KiM1P showed no statistically noticeable differences between stroke subtypes.CONCLUSIONS: Histological thrombus features vary significantly according to the underlying cause and may help to differentiate between cardioembolic and noncardioembolic stroke. In addition, our study supports the hypothesis that most cryptogenic strokes have a cardioembolic cause.

KW - Aged

KW - Aged, 80 and over

KW - Brain Ischemia

KW - Cohort Studies

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Retrospective Studies

KW - Risk Factors

KW - Stroke

KW - Thrombectomy

KW - Thrombosis

KW - Journal Article

U2 - 10.1161/STROKEAHA.117.016590

DO - 10.1161/STROKEAHA.117.016590

M3 - SCORING: Journal article

C2 - 28626055

VL - 48

SP - 2206

EP - 2210

JO - STROKE

JF - STROKE

SN - 0039-2499

IS - 8

ER -