TY - JOUR T1 - Correlation of imaging and histopathology of thrombi in acute ischemic stroke with etiology and outcome: a systematic review JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 529 LP - 534 DO - 10.1136/neurintsurg-2016-012391 VL - 9 IS - 6 AU - Waleed Brinjikji AU - Sharon Duffy AU - Anthony Burrows AU - Werner Hacke AU - David Liebeskind AU - Charles B L M Majoie AU - Diederik W J Dippel AU - Adnan H Siddiqui AU - Pooja Khatri AU - Blaise Baxter AU - Raul Nogeuira AU - Matt Gounis AU - Tudor Jovin AU - David F Kallmes Y1 - 2017/06/01 UR - http://jnis.bmj.com/content/9/6/529.abstract N2 - Background and purpose Studying the imaging and histopathologic characteristics of thrombi in ischemic stroke could provide insights into stroke etiology and ideal treatment strategies. We conducted a systematic review of imaging and histologic characteristics of thrombi in acute ischemic stroke.Materials and methods We identified all studies published between January 2005 and December 2015 that reported findings related to histologic and/or imaging characteristics of thrombi in acute ischemic stroke secondary to large vessel occlusion. The five outcomes examined in this study were (1) association between histologic composition of thrombi and stroke etiology; (2) association between histologic composition of thrombi and angiographic outcomes; (3) association between thrombi imaging and histologic characteristics; (4) association between thrombi imaging characteristics and angiographic outcomes; and (5) association between imaging characteristics of thrombi and stroke etiology. A meta-analysis was performed using a random effects model.Results There was no significant difference in the proportion of red blood cell (RBC)-rich thrombi between cardioembolic and large artery atherosclerosis etiologies (OR 1.62, 95% CI 0.1 to 28.0, p=0.63). Patients with a hyperdense artery sign had a higher odds of having RBC-rich thrombi than those without a hyperdense artery sign (OR 9.0, 95% CI 2.6 to 31.2, p<0.01). Patients with a good angiographic outcome had a mean thrombus Hounsfield unit (HU) of 55.1±3.1 compared with a mean HU of 48.4±1.9 for patients with a poor angiographic outcome (mean standard difference 6.5, 95% CI 2.7 to 10.2, p<0.001). There was no association between imaging characteristics and stroke etiology (OR 1.13, 95% CI 0.32 to 4.00, p=0.85).Conclusions The hyperdense artery sign is associated with RBC-rich thrombi and improved recanalization rates. However, there was no association between the histopathological characteristics of thrombi and stroke etiology and angiographic outcomes. ER -