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  • Mereuta, O. M. (author)

Characterization of the 'White' Appearing Clots that Cause Acute Ischemic Stroke

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • Elsevier BV,2021

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/308839
  • https://gup.ub.gu.se/publication/308839URI
  • https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106127DOI

Supplementary language notes

  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Objectives: Most clots retrieved from patients with acute ischemic stroke are 'red' in color. 'White' clots represent a less common entity and their histological composition is less known. Our aim was to investigate the composition, imaging and procedural characteristics of 'white' clots retrieved by mechanical thrombectomy. Materials and methods: Seventy five 'white' thrombi were selected by visual inspection from a cohort of 760 clots collected as part of the RESTORE registry. Clots were evaluated histopathologically. Results: Quantification of Martius Scarlett Blue stain identified platelets/other as the major component in 'white' clots' (mean of 55% of clot overall composition) followed by fibrin (31%), red blood cells (6%) and white blood cells (3%). 'White' clots contained significantly more platelets/other (p<0.001*) and collagen/calcification (p<0.001*) and less red blood cells (p<0.001*) and white blood cells (p=0.018*) than 'red' clots. The mean platelet and von Willebrand Factor expression was 43% and 24%, respectively. Adipocytes were found in four cases. 'White' clots were significantly smaller (p=0.016*), less hyperdense (p=0.005*) on computed tomography angiography/non-contrast CT and were associated with a smaller extracted clot area (p<0.001*) than 'red' clots. They primarily caused the occlusion of middle cerebral artery, were less likely to be removed by aspiration and more likely to require rescue-therapy for retrieval. Conclusions: 'White' clots represented 14% of our cohort and were platelet, von Willebrand Factor and collagen/calcification-rich. 'White' clots were smaller, less hyperdense, were associated with significantly more distal occlusions and were less successfully removed by aspiration alone than 'red' clots.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Rossi, R. (author)
  • Douglas, A. (author)
  • Gil, S. M. (author)
  • Fitzgerald, S. (author)
  • Pandit, A. (author)
  • McCarthy, R. (author)
  • Gilvarry, M. (author)
  • Ceder, ErikGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology (author)
  • Dunker, DennisGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology (author)
  • Nordanstig, Annika,1974Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xnoraz (author)
  • Redfors, PetraGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xredpe (author)
  • Jood, Katarina,1966Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xjooka (author)
  • Magoufis, Georgios (author)
  • Psychogios, K. (author)
  • Tsivgoulis, G. (author)
  • O'Hare, A. (author)
  • Power, S. (author)
  • Brennan, P. (author)
  • Nagy, A. (author)
  • Vadasz, A. (author)
  • Brinjikji, W. (author)
  • Kallmes, D. F. (author)
  • Szikora, I. (author)
  • Rentzos, Alexandros,1979Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xrenta (author)
  • Tatlisumak, TurgutGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xtatlt (author)
  • Thornton, J. (author)
  • Doyle, K. M. (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för radiologi (creator_code:org_t)

Related titles

  • In:Journal of Stroke and Cerebrovascular Diseases: Elsevier BV30:121052-3057

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