Clot composition in retrieved thrombi after mechanical thrombectomy in strokes due to carotid web.

摘要: Background The association of carotid webs (CaW) and ischemic stroke is being increasingly recognized. Data on the histologic clot architecture in strokes caused by CaW has not been previously described. Understanding thrombi histopathology may provide insight into pathophysiology CaW-related strokes. Methods This case series presents three patients with acute thought to be ipsilateral CaW. Thromboemboli were retrieved from middle cerebral artery (MCA) mechanical thrombectomy analysis was performed. Results Three aged between 41 55 years few no vascular risk factors presented symptoms concerning for an MCA territory infarction (National Institutes Health Stroke Scale (NIHSS) range 10–17). Non-contrast computed tomography (CT) Alberta Program Early CT Score (ASPECTS) 7–8 all had hyperdense vessel sign. Initial angiogram superimposed thrombus, later confirmed conventional angiography. All underwent full reperfusion. Comprehensive workup failed reveal other etiologies besides histopathologic appearance typical fresh mixed thrombi. Qualitative thrombus composition Case #1 yielded 42.5% fibrin, 50.0% red blood cells (RBC), 7.5% white (WBC); #2 46.9% 43.4% RBC, 9.7% WBC; #3 61.5% 31.8% 6.7% WBC. Conclusions large occlusion comparable reported clots etiologies. Advanced staining techniques aid further characterizing this poorly understood condition.