Thrombus composition and clinical/revascularisation outcomes
| Ref. (year) | No of patients | Staining technique | Main findings |
| Singh et al
18
2013 | 48 | H&E, Prussian-blue, Elastica-van-Gieson, Kossa, and Periodic acid-Schiff reaction IHC:CD34 (endothelial cells) | Thrombus histology does not predict success of mechanical thrombectomy |
| Hashimoto et al
10
2016 | 83 | H&E, Masson’s trichrome | Thrombi containing atheromatous gruel were associated with failed reperfusion Successful reperfusion associated with higher proportion of RBCs |
| Schuhmann et al
12
2016 | 37 | H&E, MSB IHC: CD4 (T cells), CD68 (monocytes) and vWF | No association between histological findings and clinical outcome (NIHSS score) at discharge |
| Sporns et al
42
2017 | 180 | H&E, Elastica van Gieson, Prussian blue | Fibrin rich thrombi with low RBC significantly associated with longer intervention times Thrombi with lower RBC % showed higher chances of embolisms in the thrombectomy process, suggesting a higher fragility |
| Funatsu et al
17
2019 | 101 (150 thrombi) | H&E, Masson’s trichrome, Elastica van Gieson staining to confirm vascular wall components | Lower RBC content, and high number of device passages associated with vascular wall component positive thrombi Successful recanalisation associated with vascular wall component negative thrombi |
| Douglas et al
16
2020 | 63 (91 thrombi) | MSB IHC: CD42b, vWF | Thrombus composition was not associated with stroke severity (NIHSS score ≥16) Platelet and vWF levels correlated with each other and both were inversely correlated with RBC composition Patients with platelet-rich thrombi have poorer revascularisation outcomes |
IFC, immunofluorescence staining; IHC, immunohistochemical staining; MSB, Martius scarlet blue; NIHSS, National Institutes of Health Stroke Scale; RBC, red blood cell; vWF, von Willebrand factor.