Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons

IntroductionArterial 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 t...

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Main Authors: Gang Cai, XuMing Fang, Jun Li, YuanHua Cheng, YanHui Zhang, Lan Chu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1640562/full
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author Gang Cai
Gang Cai
XuMing Fang
Jun Li
YuanHua Cheng
YanHui Zhang
Lan Chu
Lan Chu
author_facet Gang Cai
Gang Cai
XuMing Fang
Jun Li
YuanHua Cheng
YanHui Zhang
Lan Chu
Lan Chu
author_sort Gang Cai
collection DOAJ
description IntroductionArterial 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 methodsWe 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]).ResultsAmong 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).ConclusionThe 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.
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spelling doaj-art-8fd00bda82894e90b8a5e221adb214d72025-08-20T04:14:13ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-08-011610.3389/fneur.2025.16405621640562Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisonsGang Cai0Gang Cai1XuMing Fang2Jun Li3YuanHua Cheng4YanHui Zhang5Lan Chu6Lan Chu7Department of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaInstitute of Neuroscience, Soochow University, Suzhou, ChinaDepartment of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Neurology, Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaInstitute of Neuroscience, Soochow University, Suzhou, ChinaDepartment of Neurology, Beijing Amcare Hospital, Beijing, ChinaIntroductionArterial 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 methodsWe 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]).ResultsAmong 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).ConclusionThe 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.https://www.frontiersin.org/articles/10.3389/fneur.2025.1640562/fullacute ischemic strokethrombectomyarterial dissectionthrombusetiology
spellingShingle Gang Cai
Gang Cai
XuMing Fang
Jun Li
YuanHua Cheng
YanHui Zhang
Lan Chu
Lan Chu
Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons
Frontiers in Neurology
acute ischemic stroke
thrombectomy
arterial dissection
thrombus
etiology
title Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons
title_full Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons
title_fullStr Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons
title_full_unstemmed Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons
title_short Quantitative histopathologic profiling of arterial dissection-related thrombi in acute ischemic stroke: etiological comparisons
title_sort quantitative histopathologic profiling of arterial dissection related thrombi in acute ischemic stroke etiological comparisons
topic acute ischemic stroke
thrombectomy
arterial dissection
thrombus
etiology
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1640562/full
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