Changes in pathological composition of thrombi in ischemic stroke patients with hemorrhagic transformation after rescue stent implantation
KANG Tianbo
DAI Linzhi
WANG Yang
TIAN Weidong
ZHAO Dong
Abstract：Objective To investigate changes in the pathological composition of thrombi in ischemic stroke(IS)pa-tients who developed hemorrhagic transformation(HT)after rescue stent implantation(RS).Methods Thirty-nine pa-tients with IS who received endovascular therapy with RS were selected to undergo CT within 24 h after RS to observe the occurrence of HT.Immediately following mechanical transvascular thrombus extraction,new thrombus was collected.He-moglobin scavenger receptor(CD163),actin,von Willebrand factor(vWF),extracellular matrix metalloproteinase induc-er(CD147),C-reactive protein(CRP),and neutrophil trap(NET)were all identified in thrombus using immunohisto-chemistry(IHC)staining.Erythrocytes and fibrin/platelets in the thrombus were identified using hematoxylin-eosin(HE)staining,which was also used to observe their distribution and determine the mean optical density values of CD163,CD147,Actin,CRP,vWF,and NET.Additionally,the percentage of erythrocyte area and the percentage of fibrin/plate-let area were calculated.Results Of the 39 IS patients,8 had HT following RS and 31 did not have HT.Following RS,IS patients with and without HT had their pathological thrombosis components(CD163,CD147,Actin,CRP,vWF,and NET)dispersed at random throughout the thrombus,not just at the marginal location.In thrombus,CD163,CRP,and CD147 were dispersed in a punctate pattern,whereas Actin,vWF,and NET were arranged in clusters or layers.A large number of red blood cells were aggregated between the platelet trabeculae/fibrin and neutrophils.CD147 expression in thrombosis was higher in IS patients with HT after RS than in IS patients without HT after RS(P<0.05).Additionally,there were no significant differences in the percentage of erythrocytes and platelets/fibrin area in thrombus,or in the ex-pression of CD163,CRP,Actin,vWF,and NET between the two groups of patients(all P>0.05).Conclusion CD147 is highly expressed in the thrombus of IS patients who develop HT after RS,and changes in the pathological composition of the thrombus may be related to the development of HT after RS.
Keywords：ischemic strokehemorrhagic transformationrescue stent implantationthrombuspathologic compo-nentsextracellular matrix metalloproteinase inducer
Publication Date：2025-05-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 28-31 )