PT - JOURNAL ARTICLE AU - Waleed Brinjikji AU - Raul G Nogueira AU - Peter Kvamme AU - Kennith F Layton AU - Josser E Delgado Almandoz AU - Ricardo A Hanel AU - Vitor Mendes Pereira AU - Mohammed A Almekhlafi AU - Albert J Yoo AU - Babak S Jahromi AU - Matthew J Gounis AU - Biraj Patel AU - Mehdi Abbasi AU - Seán Fitzgerald AU - Oana Madalina Mereuta AU - Daying Dai AU - Ramanathan Kadirvel AU - Karen Doyle AU - Luis Savastano AU - Harry J Cloft AU - Diogo C Haussen AU - Alhamza R Al-Bayati AU - Mahmoud H Mohammaden AU - Leonardo Pisani AU - Gabriel Martins Rodrigues AU - Ike C Thacker AU - Yasha Kayan AU - Alexander Copelan AU - Amin Aghaebrahim AU - Eric Sauvageau AU - Andrew M Demchuk AU - Parita Bhuva AU - Jazba Soomro AU - Pouya Nazari AU - Donald Robert Cantrell AU - Ajit S Puri AU - John Entwistle AU - Eric C Polley AU - David F Kallmes TI - Association between clot composition and stroke origin in mechanical thrombectomy patients: analysis of the Stroke Thromboembolism Registry of Imaging and Pathology AID - 10.1136/neurintsurg-2020-017167 DP - 2021 Jul 01 TA - Journal of NeuroInterventional Surgery PG - 594--598 VI - 13 IP - 7 4099 - http://jnis.bmj.com/content/13/7/594.short 4100 - http://jnis.bmj.com/content/13/7/594.full SO - J NeuroIntervent Surg2021 Jul 01; 13 AB - Background We retrospectively evaluated the composition of retrieved clots from ischemic stroke patients to study the association between histological composition and stroke etiologyMethods Consecutive patients enrolled in the Stroke Thromboembolism Registry of Imaging and Pathology (STRIP) were included in this study. All patients underwent mechanical thrombectomy and retrieved clots were sent to a central core lab for processing. Histological analysis was performed using martius scarlet blue (MSB) staining, and quantification for red blood cells (RBCs), white blood cells (WBCs), fibrin and platelets was performed using Orbit Image Software. A Wilcoxon test was used for continuous variables and χ2 test for categorical variables.Results 1350 patients were included in this study. The overall rate of Thrombolysis In Cerebral Infarction (TICI) 2c/3 was 68%. 501 patients received tissue plasminogen activator (tPA) (37%). 267 patients (20%) had a large artery atherosclerosis (LAA) source, 662 (49%) a cardioembolic (CE) source, 301 (22%) were cryptogenic, and the remainder had other identifiable sources including hypercoagulable state or dissection. LAA thrombi had a higher mean RBC density (46±23% vs 42±22%, p=0.01) and a lower platelet density (24±18% vs 27±18%, p=0.03) than CE thrombi. Clots from dissection patients had the highest mean RBC density (50±24%) while clots from patients with a hypercoagulable state had the lowest mean RBC density (26±21%).Conclusions Our study found statistically significant but clinically insignificant differences between clots of CE and LAA etiologies. Future studies should emphasize molecular, proteomic and immunohistochemical characteristics to determine links between clot composition and etiology.Data pertaining to this study are available upon reasonable request to the corresponding author.