Department of Neurology, University Hospital Würzburg, 97080 Würzburg, Germany.
Int J Mol Sci. 2016 Feb 26;17(3):298. doi: 10.3390/ijms17030298.
Mechanical thrombectomy is a novel treatment option for patients with acute ischemic stroke (AIS). Only a few studies have previously suggested strategies to categorize retrieved clots according to their histologic composition. However, these reports did not analyze potential biomarkers that are of importance in stroke-related inflammation. We therefore histopathologically investigated 37 intracerebral thrombi mechanically retrieved from patients with AIS, and focused on the composition of immune cells and platelets. We also conducted correlation analyses of distinctive morphologic patterns (erythrocytic, serpentine, layered, red, white, mixed appearance) with clinical parameters. Most T cells and monocytes were detected in erythrocytic and red clots, in which the distribution of these cells was random. In contrast, von Willebrand factor (vWF)-positive areas co-localized with regions of fibrin and collagen. While clots with huge amounts of vWF seem to be associated with a high National Institute of Health Stroke Scale score at admission, histologic findings could not predict the clinical outcome at discharge. In summary, we provide the first histologic description of mechanically retrieved intracerebral thrombi regarding biomarkers relevant for inflammation in ischemic stroke.
机械取栓是治疗急性缺血性脑卒中（AIS）患者的一种新的治疗选择。之前只有少数研究提出了根据血栓的组织学成分对其进行分类的策略。然而，这些报告并没有分析在与中风相关的炎症中很重要的潜在生物标志物。因此，我们对 37 例 AIS 患者机械取出的颅内血栓进行了组织病理学研究，并重点研究了免疫细胞和血小板的组成。我们还对独特的形态模式（红细胞、蛇形、分层、红色、白色、混合外观）与临床参数进行了相关性分析。大多数 T 细胞和单核细胞存在于红细胞和红色血栓中，这些细胞的分布是随机的。相比之下，血管性血友病因子（vWF）阳性区域与纤维蛋白和胶原区域共存。虽然含有大量 vWF 的血栓似乎与入院时较高的国立卫生研究院卒中量表（NIHSS）评分相关，但组织学发现并不能预测出院时的临床结局。总之，我们提供了机械取栓的脑内血栓与缺血性脑卒中炎症相关的生物标志物的首次组织学描述。
