Histopathological study of thrombi retrieved from cerebral arteries following mechanical thrombectomy and correlation with radiographic, clinical outcomes, and thrombus origin

Background: Ischemic stroke is a serious condition with a high risk of lifelong neurological disability. The study aims to evaluate the histopathological composition of clots retrieved during mechanical thrombectomy in acute ischemic stroke. Patients and methods: This current study was conducted on 22 patients aged greater than 18 years of both sexes with acute ischemic stroke. All patients underwent mechanical thrombectomy and histopathological examination. Results: There was a significant difference between CD3 expression and ischemic heart disease, presumed stroke cause, Alberta stroke program early computed tomography score (ASPECT), collateral score, immediate post-procedural National Institutes of Health Stroke Scale (NIHSS), modified Rankin scale (mRS) at discharge, procedure duration, expanded thrombolysis in cerebral infarction, number of passes, and the presence of brain edema (P < 0.05). ASPECT and collateral scores were significantly higher in the white blood cell group than the fibrin group and red blood cell group (P < 0.05). There was a significant difference between clot and NIHSS immediate post-procedural, mRS at discharge, brain edema, and hemorrhage (P < 0.05). Procedure duration and no passes were significantly higher in the fibrin group compared with the red blood cell group and white blood cell groups (P < 0.05). Conclusions: Clot composition was significantly associated with the incidence of hemorrhage and mRS. A good outcome was associated with higher CD3 level and CD31 level; also, CD3 level and CD31 level had a significant relationship with multiple mechanisms of stroke and ASPECT score. Post-intervention NIHSS levels were significantly associated with CD3. Also, CD3 was significantly associated with procedural factors, including procedure duration and procedural thrombolysis in cerebral infarction.