Analyses of thrombi in acute ischemic stroke: A consensus statement on current knowledge and future directions.
Identifieur interne : 001192 ( Main/Exploration ); précédent : 001191; suivant : 001193Analyses of thrombi in acute ischemic stroke: A consensus statement on current knowledge and future directions.
Auteurs : Simon F. De Meyer [Belgique] ; Tommy Andersson [Suède] ; Blaise Baxter ; Martin Bendszus [Allemagne] ; Patrick Brouwer [Suède] ; Waleed Brinjikji [États-Unis] ; Bruce Cv Campbell [Australie] ; Vincent Costalat [France] ; Antoni Dávalos [Espagne] ; Andrew Demchuk [Canada] ; Diederik Dippel [Pays-Bas] ; Jens Fiehler [Allemagne] ; Urs Fischer [Suisse] ; Michael Gilvarry [Irlande (pays)] ; Matthew J. Gounis [États-Unis] ; Jan Gralla [Suisse] ; Olav Jansen [Allemagne] ; Tudor Jovin [États-Unis] ; David Kallmes [États-Unis] ; Pooja Khatri [États-Unis] ; Kennedy R. Lees [Royaume-Uni] ; Elena L Pez-Cancio [Espagne] ; Charles Majoie [Pays-Bas] ; Henk Marquering [Pays-Bas] ; Ana Paula Narata [France] ; Raul Nogueira [États-Unis] ; Peter Ringleb [Allemagne] ; Adnan Siddiqui [États-Unis] ; István Szikora [Hongrie] ; David Vale [Irlande (pays)] ; Rüdiger Von Kummer [Allemagne] ; Albert J. Yoo [États-Unis] ; Werner Hacke [Allemagne] ; David S. Liebeskind [États-Unis]Source :
- International journal of stroke : official journal of the International Stroke Society [ 1747-4949 ] ; 2017.
Abstract
Limited data exist on clot composition and detailed characteristics of arterial thrombi associated with large vessel occlusion in acute ischemic stroke. Advances in endovascular thrombectomy and related imaging modalities have created a unique opportunity to analyze thrombi removed from cerebral arteries. Insights into thrombus composition, etiology, physical properties and neurovascular interactions may lead to future advancements in acute ischemic stroke treatment and improved clinical outcomes. Advances in imaging techniques may enhance clot characterization and inform therapeutic decision-making prior to treatment and reveal stroke etiology to guide secondary prevention. Current imaging techniques can provide some information about thrombi, but there remains much to evaluate about relationships that may exist among thrombus composition, occlusion characteristics and treatment outcomes. Improved pathophysiological characterization of clot types, their properties and how these properties change over time, together with clinical correlates from ongoing studies, may facilitate revascularization with thrombolysis and thrombectomy. Interdisciplinary approaches covering clinical, engineering and scientific aspects of thrombus research will be key to advancing the understanding of thrombi and improving acute ischemic stroke therapy. This consensus statement integrates recent research on clots and thrombi retrieved from cerebral arteries and provides a rationale for further analyses, including current opportunities and limitations.
DOI: 10.1177/1747493017709671
PubMed: 28534706
Affiliations:
- Allemagne, Australie, Belgique, Canada, Espagne, France, Hongrie, Irlande (pays), Pays-Bas, Royaume-Uni, Suisse, Suède, États-Unis
- Alberta, Bade-Wurtemberg, Californie, Canton de Berne, Catalogne, District de Dresde, District de Karlsruhe, Géorgie (États-Unis), Hambourg, Hollande-Méridionale, Hollande-Septentrionale, Hongrie centrale, Languedoc-Roussillon, Massachusetts, Minnesota, Occitanie (région administrative), Ohio, Pennsylvanie, Saxe (Land), Schleswig-Holstein, Svealand, Texas, Victoria (État), Écosse, État de New York
- Amsterdam, Barcelone, Berne, Budapest, Calgary, Dresde, Glasgow, Hambourg, Heidelberg, Kiel, Melbourne, Montpellier, Rotterdam, Stockholm
- Université de Calgary, Université de Glasgow, Université de Melbourne
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De Meyer</name><affiliation wicri:level="1"><nlm:affiliation>1 Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>1 Laboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk</wicri:regionArea><wicri:noRegion>Kortrijk</wicri:noRegion></affiliation></author><author><name sortKey="Andersson, Tommy" sort="Andersson, Tommy" uniqKey="Andersson T" first="Tommy" last="Andersson">Tommy Andersson</name><affiliation wicri:level="3"><nlm:affiliation>2 Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>2 Department of Clinical Neuroscience, Karolinska Institute, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Baxter, Blaise" sort="Baxter, Blaise" uniqKey="Baxter B" first="Blaise" last="Baxter">Blaise Baxter</name><affiliation><nlm:affiliation>5 Department of Radiology, Erlanger Hospital, University of Tennessee, Chattanooga.</nlm:affiliation><wicri:noCountry code="subField">Chattanooga</wicri:noCountry></affiliation></author><author><name sortKey="Bendszus, Martin" sort="Bendszus, Martin" uniqKey="Bendszus M" first="Martin" last="Bendszus">Martin Bendszus</name><affiliation wicri:level="3"><nlm:affiliation>6 Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>6 Department of Neuroradiology, University of Heidelberg, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Brouwer, Patrick" sort="Brouwer, Patrick" uniqKey="Brouwer P" first="Patrick" last="Brouwer">Patrick Brouwer</name><affiliation wicri:level="3"><nlm:affiliation>3 Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>3 Department of Neuroradiology, Karolinska University Hospital, Stockholm</wicri:regionArea><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Brinjikji, Waleed" sort="Brinjikji, Waleed" uniqKey="Brinjikji W" first="Waleed" last="Brinjikji">Waleed Brinjikji</name><affiliation wicri:level="2"><nlm:affiliation>7 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>7 Department of Radiology, Mayo Clinic, Rochester, Minnesota</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Campbell, Bruce Cv" sort="Campbell, Bruce Cv" uniqKey="Campbell B" first="Bruce Cv" last="Campbell">Bruce Cv Campbell</name><affiliation wicri:level="4"><nlm:affiliation>8 Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Grattan Street, Parkville, VIC 3050, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>8 Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Grattan Street, Parkville, VIC 3050</wicri:regionArea><orgName type="university">Université de Melbourne</orgName><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Costalat, Vincent" sort="Costalat, Vincent" uniqKey="Costalat V" first="Vincent" last="Costalat">Vincent Costalat</name><affiliation wicri:level="3"><nlm:affiliation>9 Interventional and Diagnostic Neuroradiology, Montpellier University Hospital, Montpellier, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>9 Interventional and Diagnostic Neuroradiology, Montpellier University Hospital, Montpellier</wicri:regionArea><placeName><region type="region">Occitanie (région administrative)</region><region type="old region">Languedoc-Roussillon</region><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Davalos, Antoni" sort="Davalos, Antoni" uniqKey="Davalos A" first="Antoni" last="Dávalos">Antoni Dávalos</name><affiliation wicri:level="3"><nlm:affiliation>10 Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>10 Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Demchuk, Andrew" sort="Demchuk, Andrew" uniqKey="Demchuk A" first="Andrew" last="Demchuk">Andrew Demchuk</name><affiliation wicri:level="4"><nlm:affiliation>11 Department of Clinical Neurosciences and Radiology, Cumming School of Medicine, University of Calgary, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>11 Department of Clinical Neurosciences and Radiology, Cumming School of Medicine, University of Calgary</wicri:regionArea><placeName><settlement type="city">Calgary</settlement><region type="state">Alberta</region></placeName><orgName type="university">Université de Calgary</orgName></affiliation></author><author><name sortKey="Dippel, Diederik" sort="Dippel, Diederik" uniqKey="Dippel D" first="Diederik" last="Dippel">Diederik Dippel</name><affiliation wicri:level="3"><nlm:affiliation>12 Department of Neurology, Erasmus University Medical Center, Rotterdam, Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>12 Department of Neurology, Erasmus University Medical Center, Rotterdam</wicri:regionArea><placeName><settlement type="city">Rotterdam</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name><affiliation wicri:level="3"><nlm:affiliation>13 Department of Neuroradiology, University Medical Center, Hamburg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>13 Department of Neuroradiology, University Medical Center, Hamburg</wicri:regionArea><placeName><settlement type="city">Hambourg</settlement><region type="land" nuts="2">Hambourg</region></placeName></affiliation></author><author><name sortKey="Fischer, Urs" sort="Fischer, Urs" uniqKey="Fischer U" first="Urs" last="Fischer">Urs Fischer</name><affiliation wicri:level="3"><nlm:affiliation>14 Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>14 Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Gilvarry, Michael" sort="Gilvarry, Michael" uniqKey="Gilvarry M" first="Michael" last="Gilvarry">Michael Gilvarry</name><affiliation wicri:level="1"><nlm:affiliation>15 Neuravi Thromboembolic Initiative, Neuravi Ltd, Galway, Ireland.</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>15 Neuravi Thromboembolic Initiative, Neuravi Ltd, Galway</wicri:regionArea><wicri:noRegion>Galway</wicri:noRegion></affiliation></author><author><name sortKey="Gounis, Matthew J" sort="Gounis, Matthew J" uniqKey="Gounis M" first="Matthew J" last="Gounis">Matthew J. Gounis</name><affiliation wicri:level="2"><nlm:affiliation>16 Division of Neuroimaging and Intervention and New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>16 Division of Neuroimaging and Intervention and New England Center for Stroke Research, Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Gralla, Jan" sort="Gralla, Jan" uniqKey="Gralla J" first="Jan" last="Gralla">Jan Gralla</name><affiliation wicri:level="3"><nlm:affiliation>17 Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.</nlm:affiliation><country xml:lang="fr">Suisse</country><wicri:regionArea>17 Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern</wicri:regionArea><placeName><settlement type="city">Berne</settlement><region type="région" nuts="3">Canton de Berne</region></placeName></affiliation></author><author><name sortKey="Jansen, Olav" sort="Jansen, Olav" uniqKey="Jansen O" first="Olav" last="Jansen">Olav Jansen</name><affiliation wicri:level="3"><nlm:affiliation>18 Department of Radiology and Neuroradiology, UKSH, Kiel, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>18 Department of Radiology and Neuroradiology, UKSH, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Jovin, Tudor" sort="Jovin, Tudor" uniqKey="Jovin T" first="Tudor" last="Jovin">Tudor Jovin</name><affiliation wicri:level="2"><nlm:affiliation>19 Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>19 Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania</wicri:regionArea><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Kallmes, David" sort="Kallmes, David" uniqKey="Kallmes D" first="David" last="Kallmes">David Kallmes</name><affiliation wicri:level="2"><nlm:affiliation>7 Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>7 Department of Radiology, Mayo Clinic, Rochester, Minnesota</wicri:regionArea><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Khatri, Pooja" sort="Khatri, Pooja" uniqKey="Khatri P" first="Pooja" last="Khatri">Pooja Khatri</name><affiliation wicri:level="2"><nlm:affiliation>20 Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>20 Department of Neurology, University of Cincinnati, Cincinnati, Ohio</wicri:regionArea><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Lees, Kennedy R" sort="Lees, Kennedy R" uniqKey="Lees K" first="Kennedy R" last="Lees">Kennedy R. Lees</name><affiliation wicri:level="4"><nlm:affiliation>21 Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>21 Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland</wicri:regionArea><orgName type="university">Université de Glasgow</orgName><placeName><settlement type="city">Glasgow</settlement><region type="country">Écosse</region></placeName></affiliation></author><author><name sortKey="L Pez Cancio, Elena" sort="L Pez Cancio, Elena" uniqKey="L Pez Cancio E" first="Elena" last="L Pez-Cancio">Elena L Pez-Cancio</name><affiliation wicri:level="3"><nlm:affiliation>10 Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>10 Acute Stroke Unit, Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Majoie, Charles" sort="Majoie, Charles" uniqKey="Majoie C" first="Charles" last="Majoie">Charles Majoie</name><affiliation wicri:level="3"><nlm:affiliation>22 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>22 Department of Radiology, Academic Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Marquering, Henk" sort="Marquering, Henk" uniqKey="Marquering H" first="Henk" last="Marquering">Henk Marquering</name><affiliation wicri:level="3"><nlm:affiliation>22 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>22 Department of Radiology, Academic Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Narata, Ana Paula" sort="Narata, Ana Paula" uniqKey="Narata A" first="Ana Paula" last="Narata">Ana Paula Narata</name><affiliation wicri:level="1"><nlm:affiliation>24 Department of Neuroradiology, CHRU Hôpitaux de Tours, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>24 Department of Neuroradiology, CHRU Hôpitaux de Tours</wicri:regionArea><wicri:noRegion>CHRU Hôpitaux de Tours</wicri:noRegion><wicri:noRegion>CHRU Hôpitaux de Tours</wicri:noRegion></affiliation></author><author><name sortKey="Nogueira, Raul" sort="Nogueira, Raul" uniqKey="Nogueira R" first="Raul" last="Nogueira">Raul Nogueira</name><affiliation wicri:level="2"><nlm:affiliation>25 Department of Neurology, Emory University, Atlanta, Georgia, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>25 Department of Neurology, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Ringleb, Peter" sort="Ringleb, Peter" uniqKey="Ringleb P" first="Peter" last="Ringleb">Peter Ringleb</name><affiliation wicri:level="3"><nlm:affiliation>26 Department of Neurology, University of Heidelberg, Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>26 Department of Neurology, University of Heidelberg, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Siddiqui, Adnan" sort="Siddiqui, Adnan" uniqKey="Siddiqui A" first="Adnan" last="Siddiqui">Adnan Siddiqui</name><affiliation wicri:level="2"><nlm:affiliation>27 Department of Neurosurgery, University of Buffalo, Buffalo, New York, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>27 Department of Neurosurgery, University of Buffalo, Buffalo, New York</wicri:regionArea><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Szikora, Istvan" sort="Szikora, Istvan" uniqKey="Szikora I" first="István" last="Szikora">István Szikora</name><affiliation wicri:level="3"><nlm:affiliation>28 Department of Neuroradiology, National Institute of Neurosciences, Budapest, Hungary.</nlm:affiliation><country xml:lang="fr">Hongrie</country><wicri:regionArea>28 Department of Neuroradiology, National Institute of Neurosciences, Budapest</wicri:regionArea><placeName><settlement type="city">Budapest</settlement><region nuts="2">Hongrie centrale</region></placeName></affiliation></author><author><name sortKey="Vale, David" sort="Vale, David" uniqKey="Vale D" first="David" last="Vale">David Vale</name><affiliation wicri:level="1"><nlm:affiliation>15 Neuravi Thromboembolic Initiative, Neuravi Ltd, Galway, Ireland.</nlm:affiliation><country xml:lang="fr">Irlande (pays)</country><wicri:regionArea>15 Neuravi Thromboembolic Initiative, Neuravi Ltd, Galway</wicri:regionArea><wicri:noRegion>Galway</wicri:noRegion></affiliation></author><author><name sortKey="Von Kummer, Rudiger" sort="Von Kummer, Rudiger" uniqKey="Von Kummer R" first="Rüdiger" last="Von Kummer">Rüdiger Von Kummer</name><affiliation wicri:level="3"><nlm:affiliation>29 Universitätsklinikum Carl Gustav Carus, Dresden, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>29 Universitätsklinikum Carl Gustav Carus, Dresden</wicri:regionArea><placeName><region type="land" nuts="1">Saxe (Land)</region><region type="district" nuts="2">District de Dresde</region><settlement type="city">Dresde</settlement></placeName></affiliation></author><author><name sortKey="Yoo, Albert J" sort="Yoo, Albert J" uniqKey="Yoo A" first="Albert J" last="Yoo">Albert J. Yoo</name><affiliation wicri:level="2"><nlm:affiliation>30 Texas Stroke Institute, Dallas, TX, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>30 Texas Stroke Institute, Dallas, TX</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Hacke, Werner" sort="Hacke, Werner" uniqKey="Hacke W" first="Werner" last="Hacke">Werner Hacke</name><affiliation wicri:level="3"><nlm:affiliation>31 Department of Neurology, University Hospital Heidelberg, Ruprecht-Karls University, Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>31 Department of Neurology, University Hospital Heidelberg, Ruprecht-Karls University, Heidelberg</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Heidelberg</settlement></placeName></affiliation></author><author><name sortKey="Liebeskind, David S" sort="Liebeskind, David S" uniqKey="Liebeskind D" first="David S" last="Liebeskind">David S. Liebeskind</name><affiliation wicri:level="2"><nlm:affiliation>32 Neurovascular Imaging Research Core and UCLA Stroke Center, University of California, Los Angeles, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>32 Neurovascular Imaging Research Core and UCLA Stroke Center, University of California, Los Angeles, California</wicri:regionArea><placeName><region type="state">Californie</region></placeName></affiliation></author></analytic><series><title level="j">International journal of stroke : official journal of the International Stroke Society</title><idno type="eISSN">1747-4949</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Limited data exist on clot composition and detailed characteristics of arterial thrombi associated with large vessel occlusion in acute ischemic stroke. Advances in endovascular thrombectomy and related imaging modalities have created a unique opportunity to analyze thrombi removed from cerebral arteries. Insights into thrombus composition, etiology, physical properties and neurovascular interactions may lead to future advancements in acute ischemic stroke treatment and improved clinical outcomes. Advances in imaging techniques may enhance clot characterization and inform therapeutic decision-making prior to treatment and reveal stroke etiology to guide secondary prevention. Current imaging techniques can provide some information about thrombi, but there remains much to evaluate about relationships that may exist among thrombus composition, occlusion characteristics and treatment outcomes. Improved pathophysiological characterization of clot types, their properties and how these properties change over time, together with clinical correlates from ongoing studies, may facilitate revascularization with thrombolysis and thrombectomy. Interdisciplinary approaches covering clinical, engineering and scientific aspects of thrombus research will be key to advancing the understanding of thrombi and improving acute ischemic stroke therapy. This consensus statement integrates recent research on clots and thrombi retrieved from cerebral arteries and provides a rationale for further analyses, including current opportunities and limitations.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Belgique</li><li>Canada</li><li>Espagne</li><li>France</li><li>Hongrie</li><li>Irlande (pays)</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suisse</li><li>Suède</li><li>États-Unis</li></country><region><li>Alberta</li><li>Bade-Wurtemberg</li><li>Californie</li><li>Canton de Berne</li><li>Catalogne</li><li>District de Dresde</li><li>District de Karlsruhe</li><li>Géorgie (États-Unis)</li><li>Hambourg</li><li>Hollande-Méridionale</li><li>Hollande-Septentrionale</li><li>Hongrie centrale</li><li>Languedoc-Roussillon</li><li>Massachusetts</li><li>Minnesota</li><li>Occitanie (région administrative)</li><li>Ohio</li><li>Pennsylvanie</li><li>Saxe (Land)</li><li>Schleswig-Holstein</li><li>Svealand</li><li>Texas</li><li>Victoria (État)</li><li>Écosse</li><li>État de New York</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Berne</li><li>Budapest</li><li>Calgary</li><li>Dresde</li><li>Glasgow</li><li>Hambourg</li><li>Heidelberg</li><li>Kiel</li><li>Melbourne</li><li>Montpellier</li><li>Rotterdam</li><li>Stockholm</li></settlement><orgName><li>Université de Calgary</li><li>Université de Glasgow</li><li>Université de Melbourne</li></orgName></list><tree><noCountry><name sortKey="Baxter, Blaise" sort="Baxter, Blaise" uniqKey="Baxter B" first="Blaise" last="Baxter">Blaise Baxter</name></noCountry><country name="Belgique"><noRegion><name sortKey="De Meyer, Simon F" sort="De Meyer, Simon F" uniqKey="De Meyer S" first="Simon F" last="De Meyer">Simon F. De Meyer</name></noRegion></country><country name="Suède"><region name="Svealand"><name sortKey="Andersson, Tommy" sort="Andersson, Tommy" uniqKey="Andersson T" first="Tommy" last="Andersson">Tommy Andersson</name></region><name sortKey="Brouwer, Patrick" sort="Brouwer, Patrick" uniqKey="Brouwer P" first="Patrick" last="Brouwer">Patrick Brouwer</name></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Bendszus, Martin" sort="Bendszus, Martin" uniqKey="Bendszus M" first="Martin" last="Bendszus">Martin Bendszus</name></region><name sortKey="Fiehler, Jens" sort="Fiehler, Jens" uniqKey="Fiehler J" first="Jens" last="Fiehler">Jens Fiehler</name><name sortKey="Hacke, Werner" sort="Hacke, Werner" uniqKey="Hacke W" first="Werner" last="Hacke">Werner Hacke</name><name sortKey="Jansen, Olav" sort="Jansen, Olav" uniqKey="Jansen O" first="Olav" last="Jansen">Olav Jansen</name><name sortKey="Ringleb, Peter" sort="Ringleb, Peter" uniqKey="Ringleb P" first="Peter" last="Ringleb">Peter Ringleb</name><name sortKey="Von Kummer, Rudiger" sort="Von Kummer, Rudiger" uniqKey="Von Kummer R" first="Rüdiger" last="Von Kummer">Rüdiger Von Kummer</name></country><country name="États-Unis"><region name="Minnesota"><name sortKey="Brinjikji, Waleed" sort="Brinjikji, Waleed" uniqKey="Brinjikji W" first="Waleed" last="Brinjikji">Waleed Brinjikji</name></region><name sortKey="Gounis, Matthew J" sort="Gounis, Matthew J" uniqKey="Gounis M" first="Matthew J" last="Gounis">Matthew J. Gounis</name><name sortKey="Jovin, Tudor" sort="Jovin, Tudor" uniqKey="Jovin T" first="Tudor" last="Jovin">Tudor Jovin</name><name sortKey="Kallmes, David" sort="Kallmes, David" uniqKey="Kallmes D" first="David" last="Kallmes">David Kallmes</name><name sortKey="Khatri, Pooja" sort="Khatri, Pooja" uniqKey="Khatri P" first="Pooja" last="Khatri">Pooja Khatri</name><name sortKey="Liebeskind, David S" sort="Liebeskind, David S" uniqKey="Liebeskind D" first="David S" last="Liebeskind">David S. Liebeskind</name><name sortKey="Nogueira, Raul" sort="Nogueira, Raul" uniqKey="Nogueira R" first="Raul" last="Nogueira">Raul Nogueira</name><name sortKey="Siddiqui, Adnan" sort="Siddiqui, Adnan" uniqKey="Siddiqui A" first="Adnan" last="Siddiqui">Adnan Siddiqui</name><name sortKey="Yoo, Albert J" sort="Yoo, Albert J" uniqKey="Yoo A" first="Albert J" last="Yoo">Albert J. Yoo</name></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Campbell, Bruce Cv" sort="Campbell, Bruce Cv" uniqKey="Campbell B" first="Bruce Cv" last="Campbell">Bruce Cv Campbell</name></region></country><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Costalat, Vincent" sort="Costalat, Vincent" uniqKey="Costalat V" first="Vincent" last="Costalat">Vincent Costalat</name></region><name sortKey="Narata, Ana Paula" sort="Narata, Ana Paula" uniqKey="Narata A" first="Ana Paula" last="Narata">Ana Paula Narata</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Davalos, Antoni" sort="Davalos, Antoni" uniqKey="Davalos A" first="Antoni" last="Dávalos">Antoni Dávalos</name></region><name sortKey="L Pez Cancio, Elena" sort="L Pez Cancio, Elena" uniqKey="L Pez Cancio E" first="Elena" last="L Pez-Cancio">Elena L Pez-Cancio</name></country><country name="Canada"><region name="Alberta"><name sortKey="Demchuk, Andrew" sort="Demchuk, Andrew" uniqKey="Demchuk A" first="Andrew" last="Demchuk">Andrew Demchuk</name></region></country><country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Dippel, Diederik" sort="Dippel, Diederik" uniqKey="Dippel D" first="Diederik" last="Dippel">Diederik Dippel</name></region><name sortKey="Majoie, Charles" sort="Majoie, Charles" uniqKey="Majoie C" first="Charles" last="Majoie">Charles Majoie</name><name sortKey="Marquering, Henk" sort="Marquering, Henk" uniqKey="Marquering H" first="Henk" last="Marquering">Henk Marquering</name></country><country name="Suisse"><region name="Canton de Berne"><name sortKey="Fischer, Urs" sort="Fischer, Urs" uniqKey="Fischer U" first="Urs" last="Fischer">Urs Fischer</name></region><name sortKey="Gralla, Jan" sort="Gralla, Jan" uniqKey="Gralla J" first="Jan" last="Gralla">Jan Gralla</name></country><country name="Irlande (pays)"><noRegion><name sortKey="Gilvarry, Michael" sort="Gilvarry, Michael" uniqKey="Gilvarry M" first="Michael" last="Gilvarry">Michael Gilvarry</name></noRegion><name sortKey="Vale, David" sort="Vale, David" uniqKey="Vale D" first="David" last="Vale">David Vale</name></country><country name="Royaume-Uni"><region name="Écosse"><name sortKey="Lees, Kennedy R" sort="Lees, Kennedy R" uniqKey="Lees K" first="Kennedy R" last="Lees">Kennedy R. Lees</name></region></country><country name="Hongrie"><region name="Hongrie centrale"><name sortKey="Szikora, Istvan" sort="Szikora, Istvan" uniqKey="Szikora I" first="István" last="Szikora">István Szikora</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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