TY - JOUR
T1 - Analyses of thrombi in acute ischemic stroke
T2 - A consensus statement on current knowledge and future directions
AU - De Meyer, Simon F.
AU - Andersson, Tommy
AU - Baxter, Blaise
AU - Bendszus, Martin
AU - Brouwer, Patrick
AU - Brinjikji, Waleed
AU - Campbell, Bruce C.V.
AU - Costalat, Vincent
AU - Dávalos, Antoni
AU - Demchuk, Andrew
AU - Dippel, Diederik
AU - Fiehler, Jens
AU - Fischer, Urs
AU - Gilvarry, Michael
AU - Gounis, Matthew J.
AU - Gralla, Jan
AU - Jansen, Olav
AU - Jovin, Tudor
AU - Kallmes, David
AU - Khatri, Pooja
AU - Lees, Kennedy R.
AU - López-Cancio, Elena
AU - Majoie, Charles
AU - Marquering, Henk
AU - Narata, Ana Paula
AU - Nogueira, Raul
AU - Ringleb, Peter
AU - Siddiqui, Adnan
AU - Szikora, István
AU - Vale, David
AU - von Kummer, Rüdiger
AU - Yoo, Albert J.
AU - Hacke, Werner
AU - Liebeskind, David S.
N1 - Publisher Copyright:
© 2017, © 2017 World Stroke Organization.
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Limited data exist on clot composition and detailed characteristics of arterial thrombi associated with large vessel occlusion in acute ischemic stroke. Advances in endovascular thrombectomy and related imaging modalities have created a unique opportunity to analyze thrombi removed from cerebral arteries. Insights into thrombus composition, etiology, physical properties and neurovascular interactions may lead to future advancements in acute ischemic stroke treatment and improved clinical outcomes. Advances in imaging techniques may enhance clot characterization and inform therapeutic decision-making prior to treatment and reveal stroke etiology to guide secondary prevention. Current imaging techniques can provide some information about thrombi, but there remains much to evaluate about relationships that may exist among thrombus composition, occlusion characteristics and treatment outcomes. Improved pathophysiological characterization of clot types, their properties and how these properties change over time, together with clinical correlates from ongoing studies, may facilitate revascularization with thrombolysis and thrombectomy. Interdisciplinary approaches covering clinical, engineering and scientific aspects of thrombus research will be key to advancing the understanding of thrombi and improving acute ischemic stroke therapy. This consensus statement integrates recent research on clots and thrombi retrieved from cerebral arteries and provides a rationale for further analyses, including current opportunities and limitations.
AB - Limited data exist on clot composition and detailed characteristics of arterial thrombi associated with large vessel occlusion in acute ischemic stroke. Advances in endovascular thrombectomy and related imaging modalities have created a unique opportunity to analyze thrombi removed from cerebral arteries. Insights into thrombus composition, etiology, physical properties and neurovascular interactions may lead to future advancements in acute ischemic stroke treatment and improved clinical outcomes. Advances in imaging techniques may enhance clot characterization and inform therapeutic decision-making prior to treatment and reveal stroke etiology to guide secondary prevention. Current imaging techniques can provide some information about thrombi, but there remains much to evaluate about relationships that may exist among thrombus composition, occlusion characteristics and treatment outcomes. Improved pathophysiological characterization of clot types, their properties and how these properties change over time, together with clinical correlates from ongoing studies, may facilitate revascularization with thrombolysis and thrombectomy. Interdisciplinary approaches covering clinical, engineering and scientific aspects of thrombus research will be key to advancing the understanding of thrombi and improving acute ischemic stroke therapy. This consensus statement integrates recent research on clots and thrombi retrieved from cerebral arteries and provides a rationale for further analyses, including current opportunities and limitations.
KW - Stroke
KW - imaging
KW - immunohistochemistry
KW - interventional neuroradiology
KW - thrombosis
UR - https://www.scopus.com/pages/publications/85025435958
U2 - 10.1177/1747493017709671
DO - 10.1177/1747493017709671
M3 - Review article
C2 - 28534706
AN - SCOPUS:85025435958
SN - 1747-4930
VL - 12
SP - 606
EP - 614
JO - International Journal of Stroke
JF - International Journal of Stroke
IS - 6
ER -