. 2019 Jun 18;39(8):1433–1451. doi: 10.1177/0271678X19856131

Table 1.

Emerging applications of cerebral thrombus analysis to improve stroke care.

I. Thrombus analysis for acute stroke care: • Thrombus histological features and Imaging Correlation studies between histological features and thrombus imaging for non- invasive clot prediction of thrombus composition.^{33–35,38–40,47,87,98} • Thrombus histological features and acute treatments. Correlation studies between histological features and thrombolysis administration^34,40 or measures of mechanical thrombectomy^{32–34,40,46,50,87,98} for predicting recanalization feasibility, informing pre-treatment decision-making and advising on the most efficacious therapy for removing the arterial occlusion.

II. Thrombus analysis for secondary stroke prevention: • Assessing thrombus origin. Thrombus composition analysis as an additional diagnostic tool in the workup of stroke to assess thrombus origin and aid in etiology definition, in particular in cryptogenic stroke.^{34,38,39,43,45,49} Thrombus composition analysis unveiling pathogenic feature: bacterial signatures, endothelial cells, calcifications, vascular wall components, valve embolisms.^{30,45,48,49,50,52,53,56} Correlation studies between thrombus composition analysis, etiology and imaging to predict thrombus stroke etiology even when the thrombus is not extracted.¹⁰⁰ • Assessing thrombus age. Thrombus analysis and insight into the age of formation.^22,39

III. Thrombus analysis for advancing acute stroke treatment: thrombolysis and thrombectomy. • Emerging new thrombus composition targets for addressing lytic therapies. Evidence that thrombus composition deserves tailored/personalized thrombolytic approaches: e.g. targeting the von Willebrand factor or neutrophil extracellular traps.^{22,23,36,76,77} • Assessing thrombus structure to develop new thrombectomy devices. Thrombus analysis and modelling of analogs to optimize training and development of thrombectomy devices and technique.^{83–85,89,101}