Front Neurol. 2025 Aug 20;16:1640562. doi: 10.3389/fneur.2025.1640562. eCollection 2025.
ABSTRACT
INTRODUCTION: Arterial dissection is an important etiology of stroke in young adults and may demonstrate distinct thrombus characteristics. While most studies have focused on compositional differences between cardioembolic (CE) and non-cardioembolic thrombi, systematic analyses of dissection-related thrombi remain scarce. This study characterized the compositions of dissection thrombi, compared them with those of non-dissection thrombi, and explored compositional variations among stroke etiologies.
MATERIALS AND METHODS: We retrospectively analyzed the clinical data and thrombi of 230 patients with acute ischemic stroke (AIS). The thrombi were stained with hematoxylin and eosin (H&E) and digitally scanned, and their composition was analyzed based on quantified red blood cell (RBC), fibrin/other component (F/O), and white blood cell (WBC) ratios and the total thrombus area. Comparisons were made between dissection-related AIS and non-dissection etiologies (large artery atherosclerosis [LAA], CE, stroke of other determined etiology [SOE], and stroke of undetermined etiology [SUE]).
RESULTS: Among the 230 patients with acute ischemic stroke, 16 (7.0%) had dissection-related stroke and 214 (93.0%) had non-dissection stroke (59 LAA, 124 CE, 2 SOE, and 29 SUE). Compared to those in the non-dissection group, the patients in the dissection group were significantly younger and had a lower prevalence of hypertension and atrial fibrillation but higher tandem lesion frequency (all p < 0.05). Regarding the thrombus characteristics, no significant differences were observed in the RBC, F/O, or WBC ratios between the dissection and non-dissection groups or subgroups. However, the LAA thrombi were significantly smaller than those in the dissection, CE, and SUE groups (p < 0.05).
CONCLUSION: The H&E-based thrombus composition analysis did not differentiate arterial dissection from other stroke etiologies. LAA thrombi exhibited the smallest thrombus burden among the major stroke subtypes.
PMID:40908999 | PMC:PMC12404956 | DOI:10.3389/fneur.2025.1640562