Histological analysis of thrombi for differential diagnosis of ischemic stroke subtypes
https://doi.org/10.23873/2074-0506-2026-18-1-67-79
Abstract
Background. Despite a complex diagnostic evaluation, the cause of ischemic stroke (IS) remains unidentified in 23-40% of cases. The implementation of endovascular thrombectomy has created the opportunities for morphological analysis of thrombotic masses.
Objective. To compare the histological structure of thrombi in patients (pts) with different subtypes of acute IS.
Material and methods. For analysis, thrombotic masses were extracted from 107 pts with IS during aspiration thrombectomy. The relationships with clinical and procedural parameters were assessed.
Results. Fractions of erythrocytes, fibrin, detritus and leukocytes in the extracted thrombi were comparable in patients with different subtypes of IS. In pts with cardioembolic IS and IS of undetermined etiology, the plasma cell count in thrombi was statistically significantly higher than in pts with atherothrombotic IS (10 (6;13) vs. 6 (4;9) number of cells, p=0.020; 10 (5;18) vs. 6 (4;9) number of cells, p=0.035, respectively).
Conclusions. Quantitative examination of clot content may be used to distinguish between different IS subtypes. We suppose on the notion that the majority of IS of undetermined etiology was associated with cardioembolic source.
About the Authors
A. G. Komarova
Moscow Multidisciplinary Scientific and Clinical Center n.a. S.P. Botkin
Russian Federation
Russian Federation
Anna G. Komarova, Cand. Sci. (Med.), Head of Regional Vascular Center
5 2nd Botkinskiy Dr., Moscow 125284
A. A. Shavarov
Moscow Multidisciplinary Scientific and Clinical Center n.a. S.P. Botkin
Russian Federation
Russian Federation
Andrey A. Shavarov, Assoc. Prof., Cand. Sci. (Med.), Senior Researcher, Science Department
5 2nd Botkinskiy Dr., Moscow 125284
E. I. Zakurdaev
Moscow Multidisciplinary Scientific and Clinical Center n.a. S.P. Botkin
Russian Federation
Russian Federation
Eugeniy I. Zakurdaev, Cand. Sci. (Med.), Forensic Pathologist, Responsible for Biopsy Section, Pathology Department
5 2nd Botkinskiy Dr., Moscow 125284
K. E. Eroshkin
Moscow Multidisciplinary Scientific and Clinical Center n.a. S.P. Botkin
Russian Federation
Russian Federation
Kirill E. Eroshkin, Neurologist, Neurology Department
5 2nd Botkinskiy Dr., Moscow 125284
A. V. Arablinsky
Moscow Multidisciplinary Scientific and Clinical Center n.a. S.P. Botkin
Russian Federation
Russian Federation
Alexander V. Arablinsky, Dr. Sci. (Med.), Head of Department of Roentgen-Surgical Diagnostics and Management
5 2nd Botkinskiy Dr., Moscow 125284
Z. A. Bagatelia
Moscow Multidisciplinary Scientific and Clinical Center n.a. S.P. Botkin
Russian Federation
Russian Federation
Zurab A. Bagatelia, Prof., Dr. Sci. (Med.), 1st Deputy Director
5 2nd Botkinskiy Dr., Moscow 125284
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For citations:
Komarova A.G., Shavarov A.A., Zakurdaev E.I., Eroshkin K.E., Arablinsky A.V., Bagatelia Z.A. Histological analysis of thrombi for differential diagnosis of ischemic stroke subtypes. Transplantologiya. The Russian Journal of Transplantation. 2026;18(1):67-79. https://doi.org/10.23873/2074-0506-2026-18-1-67-79
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