Sunday, March 6, 2022

Characterising acute ischaemic stroke thrombi: insights from histology, imaging and emerging impedance-based technologies

This is what is so fucking bad about stroke research. The wrong goal, recanalization, which is only the first step to 100% recovery. Are the mentors and senior researchers so fucking clueless that they stop at an intermediate step rather than going for the whole shebang? Ask them and not politely.

Characterising acute ischaemic stroke thrombi: insights from histology, imaging and emerging impedance-based technologies

 
  1. Smita Patil1,
  2. Jean Darcourt2,
  3. Pierluca Messina3,
  4. Franz Bozsak3,
  5. Christophe Cognard2,
  6. Karen Doyle1,4
  1. Correspondence to Dr Karen Doyle; karen.doyle@nuigalway.ie

Treatment of acute ischaemic stroke (AIS) focuses on rapid recanalisation of the occluded artery. In recent years, advent of mechanical thrombectomy devices and new procedures have accelerated the analysis of thrombi retrieved during the endovascular thrombectomy procedure. Despite ongoing developments and progress in AIS imaging techniques, it is not yet possible to conclude definitively regarding thrombus characteristics that could advise on the probable efficacy of thrombolysis or thrombectomy in advance of treatment. Intraprocedural devices with dignostic capabilities or new clinical imaging approaches are needed for better treatment of AIS patients. In this review, what is known about the composition of the thrombi that cause strokes and the evidence that thrombus composition has an impact on success of acute stroke treatment has been examined. This review also discusses the evidence that AIS thrombus composition varies with aetiology, questioning if suspected aetiology could be a useful indicator to stroke physicians to help decide the best acute course of treatment. Furthermore, this review discusses the evidence that current widely used radiological imaging tools can predict thrombus composition. Further use of new emerging technologies based on bioimpedance, as imaging modalities for diagnosing AIS and new medical device tools for detecting thrombus composition in situ has been introduced. Whether bioimpedance would be beneficial for gaining new insights into in situ thrombus composition that could guide choice of optimum treatment approach is also reviewed.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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