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Natural History of Metameric Spinal Cord Arteriovenous Malformations. 异长性脊髓动静脉畸形的自然史。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-17 DOI: 10.1161/STROKEAHA.125.051848
Bikei Ryu, Arturo Consoli, Alessandro Sgreccia, Silvia Pizzuto, Stanislas Smajda, Federico Di Maria, Georges Rodesch
{"title":"Natural History of Metameric Spinal Cord Arteriovenous Malformations.","authors":"Bikei Ryu, Arturo Consoli, Alessandro Sgreccia, Silvia Pizzuto, Stanislas Smajda, Federico Di Maria, Georges Rodesch","doi":"10.1161/STROKEAHA.125.051848","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.051848","url":null,"abstract":"<p><strong>Background: </strong>Spinal arteriovenous metameric syndrome (SAMS) is a rare form of spinal cord arteriovenous malformations with a metameric distribution affecting the spinal cord and related structures derived from the same embryological segment. Its natural history and impact on clinical outcomes, compared with nonmetameric spinal cord arteriovenous malformations, remain unclear.</p><p><strong>Methods: </strong>This retrospective, single-center study included 253 patients with intradural spinal cord arteriovenous malformations between 2002 and 2024, that have either not been considered for embolization or followed up during the period before embolization. This study aimed to evaluate the natural history of SAMS and identify the risk factors for clinical worsening, hemorrhagic events, and angiographic worsening during observation. A stratified log-rank test and Cox proportional hazards model were used to estimate hazard ratios (HRs) and 95% CI.</p><p><strong>Results: </strong>In the overall population, the median age of onset was 24 years, females accounted for 130 patients (51.3%), and the median observational period was 19 months. This cohort included 71 patients with SAMS and 182 without SAMS. The 10-year cumulative rates of clinical worsening were 27.0% in the metameric and 18.0% in the nonmetameric group. The risk of clinical worsening and hemorrhagic events did not show statistically significant differences between the 2 groups (HR, 1.71 [95% CI, 0.83-3.54]; <i>P</i>=0.137 and HR, 1.65 [95% CI, 0.75-3.61]; <i>P</i>=0.199). The metameric group with hemorrhagic onset had the highest risk of experiencing hemorrhagic events compared with the nonmetameric group without hemorrhagic onset (HR, 4.87 [95% CI, 1.35-17.53]; <i>P</i>=0.015). The metameric group exhibited significantly higher rates of angiographic worsening compared with the nonmetameric group (HR, 11.37 [95% CI, 1.32-97.78]; <i>P</i>=0.005). The presence of nonspinal cord-associated metameric lesions did not significantly affect the natural history of SAMS.</p><p><strong>Conclusions: </strong>SAMS had higher angiographic worsening than non-SAMS. Hemorrhagic onset in SAMS was an independent predictor of rebleeding during observation, without any influence of nonspinal cord-associated metameric lesions. Close radiological follow-up and early intervention, particularly for hemorrhagic-onset cases, may be necessary to improve outcomes.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of Decompressive Craniectomy According to Location of Deep Intracerebral Hemorrhage: A SWITCH Trial Analysis. 根据深度脑出血的位置进行减压颅骨切除术的效果:一项SWITCH试验分析。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-17 DOI: 10.1161/STROKEAHA.125.052460
Alexandros A Polymeris, Matthias F Lang, Arsany Hakim, Lukas Bütikofer, Christian Fung, Seraina Beyeler, Werner Z'Graggen, Daniel Strbian, Peter Vajkoczy, Gerrit A Schubert, Andreas Gruber, Dorothee Mielke, Roland Roelz, Bernhard Siepen, David J Seiffge, Magdy H Selim, Andreas Raabe, Jürgen Beck, Urs Fischer
{"title":"Effect of Decompressive Craniectomy According to Location of Deep Intracerebral Hemorrhage: A SWITCH Trial Analysis.","authors":"Alexandros A Polymeris, Matthias F Lang, Arsany Hakim, Lukas Bütikofer, Christian Fung, Seraina Beyeler, Werner Z'Graggen, Daniel Strbian, Peter Vajkoczy, Gerrit A Schubert, Andreas Gruber, Dorothee Mielke, Roland Roelz, Bernhard Siepen, David J Seiffge, Magdy H Selim, Andreas Raabe, Jürgen Beck, Urs Fischer","doi":"10.1161/STROKEAHA.125.052460","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.052460","url":null,"abstract":"<p><strong>Background: </strong>Decompressive craniectomy (DC) seemed to reduce the risk of death or profound disability (modified Rankin Scale score, 5-6) after deep intracerebral hemorrhage (ICH) by an absolute 13% (95% CI, 0%-26%) in the SWITCH trial (Swiss Trial of Decompressive Craniectomy versus Best Medical Treatment of Spontaneous Supratentorial Intracerebral Hemorrhage). Whether the effect of DC differs by ICH location is unknown.</p><p><strong>Methods: </strong>Post hoc analysis of participants with supratentorial severe deep ICH from the intention-to-treat population of the SWITCH randomized controlled trial. We categorized ICH as involving (1) the basal ganglia (BG) alone, (2) BG and the posterior limb of the internal capsule (PLIC), or (3) BG, PLIC, and thalamus. We examined the interaction between ICH location and DC's effect on primary (modified Rankin Scale score, 5-6) and secondary outcomes (death; full modified Rankin Scale score range) at 180 days using unadjusted and adjusted logistic or survival models.</p><p><strong>Results: </strong>Of 197 participants comprising the trial's intention-to-treat population, 184 were available for analysis (median age, 61 years; 59 women; 91 randomized to DC plus best medical treatment; and 93 to best medical treatment). ICH involved BG alone in 26 (14%), BG+PLIC in 94 (51%), and BG+PLIC+thalamus in 64 participants (35%). The marginal risk of the primary outcome after adjustment for age, ICH severity, and volume was lower with DC by 15.6% (95% CI, -49.2% to 18.1%) in participants with ICH of BG alone, by 11.4% (-29.3% to 6.6%) in those with ICH of BG+PLIC, and by 9% (-31% to 12.9%) in those with ICH of BG+PLIC+thalamus, without evidence for treatment-by-location interaction (<i>P</i>=0.95). Secondary outcome analyses yielded consistent results.</p><p><strong>Conclusions: </strong>The potential benefits of DC seemed preserved regardless of the location of severe deep ICH.</p><p><strong>Registration: </strong>URL: https://www.clinicaltrials.gov; Unique identifier: NCT02258919.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Carotid Stenting for Tandem Lesions in Patients Randomized to Endovascular Treatment With or Without Thrombolysis: Results From the IRIS Individual Participant Data Meta-Analysis. 随机接受血管内溶栓或不溶栓治疗的串联病变患者的急性颈动脉支架植入术:来自IRIS个体参与者数据荟萃分析的结果
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-17 DOI: 10.1161/STROKEAHA.124.050117
Fabiano Cavalcante, Kilian Treurniet, Johannes Kaesmacher, Manon Kappelhof, Roman Rohner, Pengfei Yang, Jianmin Liu, Kentaro Suzuki, Bernard Yan, Theodora van Elk, Lei Zhang, Maarten Uyttenboogaart, Wenjie Zi, Imad Derraz, Yongwei Zhang, Chrysanthi Papagiannaki, Hal Rice, Pengfei Xing, Kazumi Kimura, Peter Mitchel, Philipp Bücke, Changwei Guo, Vincent Costalat, Romain Bourcier, Daan Nieboer, Hester Lingsma, Jan Gralla, Urs Fischer, Yvo Roos, Charles Majoie
{"title":"Acute Carotid Stenting for Tandem Lesions in Patients Randomized to Endovascular Treatment With or Without Thrombolysis: Results From the IRIS Individual Participant Data Meta-Analysis.","authors":"Fabiano Cavalcante, Kilian Treurniet, Johannes Kaesmacher, Manon Kappelhof, Roman Rohner, Pengfei Yang, Jianmin Liu, Kentaro Suzuki, Bernard Yan, Theodora van Elk, Lei Zhang, Maarten Uyttenboogaart, Wenjie Zi, Imad Derraz, Yongwei Zhang, Chrysanthi Papagiannaki, Hal Rice, Pengfei Xing, Kazumi Kimura, Peter Mitchel, Philipp Bücke, Changwei Guo, Vincent Costalat, Romain Bourcier, Daan Nieboer, Hester Lingsma, Jan Gralla, Urs Fischer, Yvo Roos, Charles Majoie","doi":"10.1161/STROKEAHA.124.050117","DOIUrl":"https://doi.org/10.1161/STROKEAHA.124.050117","url":null,"abstract":"<p><strong>Background: </strong>Equipoise persists whether patients with stroke with carotid tandem lesions undergoing endovascular treatment (EVT) should undergo acute carotid stenting, and whether intravenous thrombolysis (IVT) before EVT should influence this decision. We assessed functional and safety outcomes of acute carotid stenting in patients with carotid tandem lesions randomized to IVT plus EVT or EVT alone.</p><p><strong>Methods: </strong>Individual participant data meta-analysis of 6 randomized clinical trials conducted in Asia, Europe, and Oceania between 2017 and 2021 investigating IVT plus EVT versus EVT alone in patients with carotid tandem lesions presenting directly to EVT-capable centers. The primary outcome was the 90-day modified Rankin Scale score, assessed with mixed-effect ordinal regression models. Safety outcomes were any intracranial hemorrhage and symptomatic intracranial hemorrhage. A secondary analysis used inverse probability of treatment weighting. Treatment effect heterogeneity between IVT plus EVT and EVT alone was assessed in a 2-step meta-analysis.</p><p><strong>Results: </strong>Overall, 340 of 2267 (15%) patients had carotid tandem lesions with 113 of 329 (34%) undergoing acute carotid stenting. Stenting was associated with better 90-day functional outcomes (adjusted common odds ratio, 1.60 [95% CI, 1.03-2.47]), confirmed in inverse probability of treatment weighting analysis (adjusted common odds ratio, 1.66 [95% CI, 1.08-2.54]). Patients undergoing stenting had no statistically significant higher rates of any intracranial hemorrhage (44% versus 35%; adjusted odds ratio, 1.30 [95% CI, 0.79-2.15]) and symptomatic intracranial hemorrhage (6.3% versus 3.7%; adjusted odds ratio, 2.09 [95% CI, 0.78-5.59]). No heterogeneity in treatment effect was observed in patients randomized to IVT plus EVT (adjusted common odds ratio, 2.07 [95% CI, 1.06-4.07]) or EVT alone (1.21 [95% CI, 0.59-2.50]; <i>P</i> interaction=0.81).</p><p><strong>Conclusions: </strong>In this international individual participant data meta-analysis of patients with carotid tandem lesions randomized to EVT alone or IVT followed by EVT, acute carotid stenting during EVT was associated with better functional outcomes, and this association was not modified by prior treatment with IVT.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revolution in Stroke Treatment Over 50 Years and Predicting Stroke Care in 2050. 50年来中风治疗的革命和2050年中风护理的预测。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-16 DOI: 10.1161/STROKEAHA.125.052583
Joseph P Broderick
{"title":"Revolution in Stroke Treatment Over 50 Years and Predicting Stroke Care in 2050.","authors":"Joseph P Broderick","doi":"10.1161/STROKEAHA.125.052583","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.052583","url":null,"abstract":"<p><p>This article describes the remarkable progress over the past 50 years in acute stroke therapy, stroke prevention, and, to a lesser extent, stroke recovery, and forecasts advances in stroke care for 2050. Stroke has gone from an untreatable and unpreventable disease to a disease with effective medical and interventional treatments for acute ischemic and hemorrhagic stroke, many new medical, surgical, and interventional treatments for primary and secondary stroke prevention, and the beginnings of a revolution in our understanding of the neural code that portends a great future for stroke recovery. Progress in management of stroke risk factors has been mixed, with a major increase in obesity but a decrease in the prevalence of smoking, as well as better control of hypertension and hyperlipidemia in the United States and other high-income countries. The incidence rate of stroke in the US population studies has decreased, but with recent increases in younger segments of the population. Because age remains the most important risk factor for stroke, the burden of stroke is likely to continue to increase as the population ages. In 2050, we will use artificial intelligence to pull clinical trial data from multiple trials in the context of a patient's demographics, medical history, and biometric, imaging, and laboratory data to recommend the best treatment for that patient-true precision medicine. Making these precision treatments in the hospital, clinic, and home settings available to everyone, regardless of geographic, social, and economic situation, is one of our challenges of the next century. As we make greater progress in stroke prevention, acute treatment, and stroke recovery, we will need larger trials and more efficient trial designs. Large trials will require global efforts. The last 50 years have been about advances in stroke prevention and acute treatment. The next century will be about advances in recovery and rehabilitation after stroke and addressing current global disparities in access to proven therapies. Until we can mitigate mechanisms associated with aging, stroke will remain common and a tremendous societal and financial burden. We have made a significant dent in this burden over the past 50 years; the best is yet to come.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
PET Imaging of Carotid Atherosclerosis: Methodology, Implications, and Applications in Neurovascular Disease. 颈动脉粥样硬化的PET成像:方法、意义和在神经血管疾病中的应用。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-14 DOI: 10.1161/STROKEAHA.125.050399
Shiv Bhakta, John J McCabe, Jason M Tarkin, Mohammed M Chowdhury, Jessica Redgrave, James H F Rudd, Peter J Kelly, Elizabeth A Warburton, Nicholas R Evans
{"title":"PET Imaging of Carotid Atherosclerosis: Methodology, Implications, and Applications in Neurovascular Disease.","authors":"Shiv Bhakta, John J McCabe, Jason M Tarkin, Mohammed M Chowdhury, Jessica Redgrave, James H F Rudd, Peter J Kelly, Elizabeth A Warburton, Nicholas R Evans","doi":"10.1161/STROKEAHA.125.050399","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.050399","url":null,"abstract":"<p><p>Carotid atherosclerosis is a significant cause of incident and recurrent ischemic stroke, with risk not solely related to the degree of luminal stenosis. Multimodal imaging approaches, including positron emission tomography/computed tomography and positron emission tomography/magnetic resonance imaging, can provide anatomic and molecular evaluation of the atherosclerotic plaque in vivo. Plaque pathophysiology-including the key processes of inflammation and microcalcification-may help characterize stroke risk beyond conventional anatomic assessment alone. This review discusses the use of positron emission tomography in the investigation of carotid atherosclerosis, including methodological considerations, its contributions to our understanding of the underlying disease processes, and how imaging can be used in interventional trials. The clinical implications and potential future applications of positron emission tomography in the assessment and treatment of cerebrovascular disease are also examined.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tenecteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: A Meta-Analysis of Randomized Controlled Trials. 替奈普酶治疗急性缺血性中风4.5 ~ 24小时:随机对照试验的荟萃分析
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-13 DOI: 10.1161/STROKEAHA.125.053256
Zixin Wang, Jiamin Li, Xinyi Wang, Boyi Yuan, Jiameng Li, Qingfeng Ma
{"title":"Tenecteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: A Meta-Analysis of Randomized Controlled Trials.","authors":"Zixin Wang, Jiamin Li, Xinyi Wang, Boyi Yuan, Jiameng Li, Qingfeng Ma","doi":"10.1161/STROKEAHA.125.053256","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.053256","url":null,"abstract":"<p><strong>Background: </strong>Whether TNK (tenecteplase) benefits patients with acute ischemic stroke treated within 4.5 to 24 hours remains uncertain, and no previous meta-analysis has differentiated between clinical settings where endovascular thrombectomy (EVT) is unavailable or permitted, leading to pooled distinct clinical contexts and obscuring a clear estimation of TNK's net effect.</p><p><strong>Methods: </strong>We searched for randomized controlled trials comparing intravenous TNK of 0.25 mg/kg with standard care or placebo in adults within 4.5 to 24 hours after acute ischemic stroke onset. The primary outcome was excellent functional outcome (modified Rankin Scale score, 0-1) at 90 days, with additional efficacy and safety end points. A random-effects meta-analysis was performed both overall and within predefined subgroups, stratified by whether EVT was permitted in individual studies (non-EVT versus EVT-permitted).</p><p><strong>Results: </strong>Four multicenter randomized controlled trials enrolling 1278 patients were included. TNK significantly increased excellent functional outcome (odds ratio [OR], 1.34 [95% CI, 1.06-1.71]; <i>P</i>=0.02) at 90 days and recanalization (OR, 3.30 [95% CI, 1.59-6.84]; <i>P</i>=0.001) compared with the control group, whereas good functional outcome (modified Rankin Scale score, 0-2), reperfusion, and early neurological improvement did not differ significantly. Subgroup analyses of 596 patients in the non-EVT subgroup showed that TNK significantly improved excellent functional outcome (OR, 1.46 [95% CI, 1.02-2.08]; <i>P</i>=0.04), good functional outcome (OR, 1.50 [95% CI, 1.07-2.09]; <i>P</i>=0.02), recanalization (OR, 6.17 [95% CI, 3.36-11.33]; <i>P</i><0.00001), and early neurological improvement (OR, 3.21 [95% CI, 1.82-5.66]; <i>P</i><0.0001). However, in the EVT-permitted subgroup of 682 patients, TNK only improved recanalization (OR, 2.36 [95% CI, 1.34-4.17]; <i>P</i>=0.003). No significant differences were observed between TNK and control in the risks of symptomatic intracerebral hemorrhage or 90-day mortality, either in the overall or subgroup analyses.</p><p><strong>Conclusions: </strong>TNK improves excellent functional outcomes and recanalization in patients with acute ischemic stroke treated within 4.5 to 24 hours, without increasing the risks of symptomatic intracerebral hemorrhage or mortality. Notably, extended-window TNK provides greater additional benefits when EVT is inaccessible, establishing its role as an alternative reperfusion strategy in resource-limited settings.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inhibiting Monocyte Migration Reduces Arterial Thrombosis and Facilitates Thrombolysis. 抑制单核细胞迁移可减少动脉血栓形成并促进溶栓。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-10 DOI: 10.1161/STROKEAHA.125.052352
Hee Jeong Jang, Jiwon Kim, Ha Kim, Taesu Kim, Jinyong Chung, Sebastian Cremer, Marvin Krohn-Grimberghe, Eo-Jin Kim, Dawid Schellingerhout, Matthias Nahrendorf, Dong-Eog Kim
{"title":"Inhibiting Monocyte Migration Reduces Arterial Thrombosis and Facilitates Thrombolysis.","authors":"Hee Jeong Jang, Jiwon Kim, Ha Kim, Taesu Kim, Jinyong Chung, Sebastian Cremer, Marvin Krohn-Grimberghe, Eo-Jin Kim, Dawid Schellingerhout, Matthias Nahrendorf, Dong-Eog Kim","doi":"10.1161/STROKEAHA.125.052352","DOIUrl":"https://doi.org/10.1161/STROKEAHA.125.052352","url":null,"abstract":"<p><strong>Background: </strong>Monocytes contribute to the initiation and propagation of venous thrombosis. Little is known about the roles monocytes play in arterial thrombosis, the cause of stroke and myocardial infarction.</p><p><strong>Methods: </strong>We investigated how CCR2 (chemokine receptor 2) knockout (<sup>-/-</sup>)-mediated monocyte deficiency affects platelet function, blood coagulation, thrombus volume, and thrombolytic susceptibility in 666 male mice with FeCl<sub>3</sub>-mediated carotid arterial thrombosis, including 365 C57BL/6 wild type (WT) mice, 295 CCR2<sup>-/-</sup> mice, and 6 CX3CR1-GFP (CX3C chemokine receptor 1-green fluorescent protein) mice.</p><p><strong>Results: </strong>Intravital microscopy and flow cytometry showed that both neutrophils and monocytes were recruited to the acute arterial thrombus, as observed 30 minutes postthrombosis. Platelet function tests demonstrated platelet aggregation to be lower in the whole blood of CCR2<sup>-</sup><sup>/-</sup> mice (versus C57BL/6 WT mice) but not in their leukocyte-free platelet-rich plasma, suggesting this platelet dysfunction is cell-mediated. Flow cytometry experiments revealed lower numbers of monocyte-platelet aggregates in the blood of CCR2<sup>-</sup><sup>/-</sup> mice, compared with C57BL/6 WT mice. Blood levels of FXIII (factor XIII) and monocyte levels of FXIII-A were increased after carotid thrombosis in C57BL/6 WT mice but not CCR2<sup>-</sup><sup>/-</sup> mice. Further, in vivo micro-computed tomography-based thrombus imaging using fibrin-targeted gold nanoparticles and histology showed that CCR2<sup>-</sup><sup>/-</sup> mice had smaller thrombi (0.112±0.002 mm<sup>3</sup>, n=22) than C57BL/6 WT mice (0.125±0.007 mm<sup>3</sup>, n=27; <i>P</i><0.01), with increased porosity and reduced fibrin cross-linking. Moreover, tPA (tissue-type plasminogen activator) mediated thrombus volume reduction progressed up to ≈1 hour faster during the initial 3-hour period in CCR2<sup>-</sup><sup>/-</sup> mice and CCR2-siRNA-treated mice, compared with C57BL/6 WT mice. In addition, clopidogrel reduced baseline thrombus volume more, but CCR2<sup>-</sup><sup>/-</sup> better facilitated tPA-mediated thrombolysis.</p><p><strong>Conclusions: </strong>CCR2 antagonism decreases platelet aggregation and reduces FXIII (factor XIII) levels in blood and monocytes, thus driving arterial thrombosis towards the generation of a relatively small, porous, more lysable clot.</p>","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of Concern: "Fractalkine Enhances Hematoma Resolution and Improves Neurological Function via CX3CR1/AMPK/PPARγ Pathway After GMH". 表达担忧:“Fractalkine通过CX3CR1/AMPK/PPARγ通路增强血肿消退并改善GMH后神经功能”。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-09 DOI: 10.1161/STR.0000000000000508
{"title":"Expression of Concern: \"Fractalkine Enhances Hematoma Resolution and Improves Neurological Function via CX3CR1/AMPK/PPARγ Pathway After GMH\".","authors":"","doi":"10.1161/STR.0000000000000508","DOIUrl":"https://doi.org/10.1161/STR.0000000000000508","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of Concern for: "Isoflurane Post-Treatment Ameliorates GMH-Induced Brain Injury in Neonatal Rats". 表达关注:“异氟醚治疗后可改善gmh诱导的新生大鼠脑损伤”。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-09 DOI: 10.1161/STR.0000000000000497
{"title":"Expression of Concern for: \"Isoflurane Post-Treatment Ameliorates GMH-Induced Brain Injury in Neonatal Rats\".","authors":"","doi":"10.1161/STR.0000000000000497","DOIUrl":"https://doi.org/10.1161/STR.0000000000000497","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Expression of Concern for: "Dihydrolipoic Acid Inhibits Lysosomal Rupture and NLRP3 Through Lysosome-Associated Membrane Protein-1/Calcium/Calmodulin-Dependent Protein Kinase II/TAK1 Pathways After Subarachnoid Hemorrhage in Rat". 关注表达:“大鼠蛛网膜下腔出血后,二氢硫酸通过溶酶体相关膜蛋白-1/钙/钙调素依赖性蛋白激酶II/TAK1途径抑制溶酶体破裂和NLRP3”。
IF 8.9 1区 医学
Stroke Pub Date : 2025-10-09 DOI: 10.1161/STR.0000000000000503
{"title":"Expression of Concern for: \"Dihydrolipoic Acid Inhibits Lysosomal Rupture and NLRP3 Through Lysosome-Associated Membrane Protein-1/Calcium/Calmodulin-Dependent Protein Kinase II/TAK1 Pathways After Subarachnoid Hemorrhage in Rat\".","authors":"","doi":"10.1161/STR.0000000000000503","DOIUrl":"https://doi.org/10.1161/STR.0000000000000503","url":null,"abstract":"","PeriodicalId":21989,"journal":{"name":"Stroke","volume":" ","pages":""},"PeriodicalIF":8.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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