Abstract
Background and PurposeApproximately 30% of strokes are cryptogenic despite an exhaustive in-hospital work-up. Analysis of clot composition following endovascular treatment could provide insight into stroke etiology. T-cells already have been shown to be a major component of vulnerable atherosclerotic carotid lesions. We therefore hypothesize that T-cell content in intracranial thrombi may also be a biomarker of atherothrombotic origin.Materials and MethodsWe histopathologically investigated 54 consecutive thrombi retrieved after mechanical thrombectomy in acute stroke patients. First, thrombi were classified as fibrin-dominant, erythrocyte-dominant or mixed pattern. We then performed quantitative analysis of CD3+ cells on immunohistochemically-stained thrombi and compared T-cell content between “atherothrombotic”, “cardioembolism” and “other causes” stroke subtypes.ResultsFourteen (26%) thrombi were defined as fibrin-dominant, 15 (28%) as erythrocyte-dominant, 25 (46%) as mixed. The stroke cause was defined as “atherothrombotic” in 10 (18.5%), “cardioembolism” in 25 (46.3%), and “other causes” in 19 (35.2%). Number of T-cells was significantly higher in thrombi from the “atherothrombotic” group (53.60 ± 28.78) than in the other causes (21.77 ± 18.31; p<0.0005) or the “cardioembolism” group (20.08 ± 15.66; p<0.0003).ConclusionsThe CD3+ T-cell count in intracranial thrombi was significantly higher in “atherothrombotic” origin strokes compared to all other causes. Thrombi with high content of CD3+ cells are more likely to originate from an atherosclerotic plaque.
Highlights
Stroke is a significant public health problem, with an incidence and a prevalence of 9 and 30.7 million respectively, according to the World Health Organization
We histopathologically investigated 54 consecutive thrombi retrieved after mechanical thrombectomy in acute stroke patients
Number of Tcells was significantly higher in thrombi from the “atherothrombotic” group (53.60 ± 28.78) than in the other causes (21.77 ± 18.31; p
Summary
Stroke is a significant public health problem, with an incidence and a prevalence of 9 and 30.7 million respectively, according to the World Health Organization. It is a heterogeneous disease, with more than 150 causes identified [1]. Few studies on intracranial thrombi have been undertaken to date They mainly reported variable architecture of cerebral thrombi with different components such as fibrin, red blood cells (RBC) and platelets [4,5]. Studying histopathologic clot composition of intracranial thrombi could potentially have high clinical relevance. Analysis of clot composition following endovascular treatment could provide insight into stroke etiology. We hypothesize that T-cell content in intracranial thrombi may be a biomarker of atherothrombotic origin
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