Histological Examination of Thrombi in Patients with Cerebral Infarction in Embolic Stroke of Undetermined Source

Abstract

Objective: We pathologically examined thrombi collected by mechanical thrombectomy in Embolic Stroke of Undetermined Source (ESUS). Methods: We examined the thrombi of acute ischemic stroke patients who underwent mechanical thrombectomy from January 2017 to June 2018. We histopathologically investigated the thrombi in ESUS patients, and performed a comparison with the thrombi of cardioembolic stroke. Results: Mechanical thrombectomy was performed in 35 patients, and the thrombus were obtained from five patients diagnosed as ESUS. The thrombus in one patient consisted of neutrophils and nuclear crush cells not only the red blood cells, and another one was included atheroma which was different from the typical clot in one patient. In the 25 cardioembolic stroke patients in this study, the thrombi were all constructed of fibrin, red blood cells, and platelets. Conclusion: In this pathological study, a difference was recognized in the clot components of ESUS. The results suggest that a pathological examination of thrombi obtained by mechanical thrombectomy is useful because there is a possibility that we can recognize the etiology of ESUS, and choose the best treatment for prevention of recurrence of stroke.