ORIGINAL RESEARCH article
Front. Neurol.
Sec. Endovascular and Interventional Neurology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1640562
This article is part of the Research TopicAdvances in the Understanding, Diagnosis, and Management of Intracranial and Extracranial Arterial DissectionsView all 12 articles
Quantitative Histopathologic Profiling of Arterial Dissection-Related Thrombi in Acute Ischemic Stroke: Etiological Comparisons
Provisionally accepted
- 1Affiliated Hospital of Guizhou Medical University, Guiyang, China
- 2Soochow University Institute of Neuroscience, Suzhou, China
- 3Institute of Neuroscience, Soochow University, Suzhou, China
- 4Department of Neurology, Beijing Amcare Hospital, Beijing, China
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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.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.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).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.
Keywords: Acute ischemic stroke, Thrombectomy, Arterial dissection, Thrombus, etiology
Received: 03 Jun 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 CAI, Fang, Li, Cheng, Zhang and Chu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
GANG CAI, Affiliated Hospital of Guizhou Medical University, Guiyang, China
Lan Chu, Institute of Neuroscience, Soochow University, Suzhou, China
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