Global Health Neurology Lab, Sydney, NSW 2000, Australia.
Neurovascular Imaging Laboratory, Ingham Institute for Applied Medical Research, Clinical Sciences Stream, Sydney, NSW 2170, Australia.
Int J Mol Sci. 2022 Oct 15;23(20):12373. doi: 10.3390/ijms232012373.
Stroke is a leading cause of death and disability in the world, and the provision of reperfusion therapy and endovascular therapy, in particular, have revolutionized the treatment of patients with stroke and opened opportunities to look at brain clots retrieved after the procedure. The use of histopathology and molecular profiling of clots is of growing research and clinical interest. However, its clinical implications and incorporation within stroke workflows remain suboptimal. Recent studies have indicated that the study of brain clots may inform the mechanism of stroke and hence guide treatment decision-making in select groups of patients, especially patients without a defined cause or known mechanism. This article provides a comprehensive overview of various clot histopathological examinations in acute stroke-care settings, their clinical utility, and existing gaps and opportunities for further research. We also provide targeted recommendations to improve clot analysis workflow, hence standardizing its incorporation into clinical practice.
中风是世界范围内导致死亡和残疾的主要原因，而再灌注治疗和血管内治疗的提供，特别是改变了中风患者的治疗方式，并为手术后取出的脑栓提供了新的机会。血栓的组织病理学和分子分析越来越受到研究和临床的关注。然而，其临床意义及其在中风工作流程中的应用仍不尽人意。最近的研究表明，对脑栓的研究可以为中风的机制提供信息，从而为某些特定患者（尤其是没有明确病因或已知机制的患者）的治疗决策提供指导。本文全面概述了急性中风护理环境中各种血栓的组织病理学检查，以及其临床应用，同时还探讨了当前存在的差距和进一步研究的机会。我们还提供了有针对性的建议，以改善血栓分析工作流程，从而将其标准化纳入临床实践。
