Analyses of thrombi in acute ischemic stroke: A consensus statement on current knowledge and future directions.

De Meyer, Simon F; Andersson, Tommy; Baxter, Blaise; Bendszus, Martin; Brouwer, Patrick; Brinjikji, Waleed; Campbell, Bruce Cv; Costalat, Vincent; Dávalos, Antoni; Demchuk, Andrew; Dippel, Diederik; Fiehler, Jens; Fischer, Urs; Gilvarry, Michael; Gounis, Matthew J; Gralla, Jan; Jansen, Olav; Jovin, Tudor; Kallmes, David; Khatri, Pooja; ... (2017). Analyses of thrombi in acute ischemic stroke: A consensus statement on current knowledge and future directions. International journal of stroke, 12(6), pp. 606-614. SAGE 10.1177/1747493017709671

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Fischer, Urs and Gralla, Jan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1747-4949

Publisher:

SAGE

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

04 Aug 2017 13:29

Last Modified:

04 Aug 2017 13:29

Publisher DOI:

10.1177/1747493017709671

PubMed ID:

28534706

Uncontrolled Keywords:

Stroke; imaging; immunohistochemistry; interventional neuroradiology; thrombosis

URI:

https://boris.unibe.ch/id/eprint/101631

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