Evidence map›Paper›PMID 37769315›Full record

ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2025

Endotheliitis and cytokine storm as a mechanism of clot formation in COVID-19 ischemic stroke patients: A histopathologic study of retrieved clots.

Waleed Brinjikji, David F Kallmes, Renu Virmani, Simon F de Meyer, Albert J Yoo, William Humphries, Osama O Zaidat, Mohamed S Teleb, Jesse G Jones, Adnan H Siddiqui and 12 more

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Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Waleed BrinjikjiDepartment of Radiology, Mayo Clinic, Rochester, MN, USA.
David F KallmesDepartment of Radiology, Mayo Clinic, Rochester, MN, USA.ORCID 0000-0002-8495-0040
Renu VirmaniDepartment of Pathology, CVPath Institute, Gaithersburg, MD, USA.
Simon F de MeyerLaboratory for Thrombosis Research, KU Leuven Campus Kulak Kortrijk, Kortrijk, Belgium.
Albert J YooNeurointervention, Texas Stroke Institute, Plano, TX, USA.
William HumphriesWellstar Health System, Kennestone Hospital, Marietta, GA, USA.
Osama O ZaidatDepartment of Neuroscience, Mercy Health St Vincent Medical Center, Toledo, OH, USA.
Mohamed S TelebNeurointerventional Surgery, Stroke, and Neurocritical Care, Banner Health, Mesa, AZ, USA.
Jesse G JonesDepartment of Neurosurgery, University of Alabama, Birmingham, AL, USA.ORCID 0000-0002-2682-9736
Adnan H SiddiquiDepartments of Neurosurgery and Radiology, State University of New York at Buffalo, New York, NY, USA.
Tommy AnderssonDepartment of Neuroradiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.
Raul G NogueiraDepartment of Neurology and Neurosurgery, University of Pittsburgh Medical Center, UPMC Stroke Institute, Pittsburgh, PA, USA.
Sara Molina GilDepartment of Physiology and Galway Neuroscience Centre, School of Medicine, National University of Ireland, Galway, Ireland.
Andrew DouglasDepartment of Physiology and Galway Neuroscience Centre, School of Medicine, National University of Ireland, Galway, Ireland.
Rosanna RossiDepartment of Physiology and Galway Neuroscience Centre, School of Medicine, National University of Ireland, Galway, Ireland.ORCID 0000-0002-3656-2908
Alexander RentzosDepartment of Interventional and Diagnostic Neuroradiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Erik CederDepartment of Interventional and Diagnostic Neuroradiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Jeanette CarlqvistDepartment of Interventional and Diagnostic Neuroradiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Dennis DunkerDepartment of Interventional and Diagnostic Neuroradiology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
Katarina JoodDepartment of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Turgut TatlisumakDepartment of Clinical Neurosciences, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
Karen M DoyleDepartment of Physiology and Galway Neuroscience Centre, School of Medicine, National University of Ireland, Galway, Ireland.ORCID 0000-0001-8984-6296

Funding

Impact of Clot Histological and Physical Properties on Revascularization Strategies in Acute Ischaemic Stroke - Administrative SupplementR01NS105853 · NINDS · MAYO CLINIC ROCHESTER · PI BRINJIKJI, WALEED · 2018 to 2022
$2.0M
NINDS NIH HHS R01 NS105853
6 · The paper itself

Abstract

BackgroundStudies during the COVID-19 pandemic have demonstrated an association between COVID-19 virus infection and the development of acute ischemic stroke, particularly large vessel occlusion (LVO). Studying the characteristics and immunohistochemistry of retrieved stroke emboli during mechanical thrombectomy for LVO may offer insights into the pathogenesis of LVO in COVID-19 patients. We examined retrieved COVID-19 emboli from the STRIP, EXCELLENT, and RESTORE registries and compared their characteristics to a control group.MethodsWe identified COVID-positive LVO patients from the STRIP, RESTORE, and EXCELLENT studies who underwent mechanical thrombectomy. These patients were matched to a control group controlling for stroke etiology based on Trial of Org 10172 in Acute Stroke Treatment criteria. All clots were stained with Martius Scarlet Blue (MSB) along with immunohistochemistry for interleukin-6 (IL-6), C-reactive protein (CRP), von Willebrand factor (vWF), CD66b, fibrinogen, and citrullinated Histone H3. Clot composition was compared between groups.ResultsNineteen COVID-19-positive patients and 38 controls were included. COVID-19-positive patients had a significantly higher percentage of CRP and vWF. There was no difference in IL-6, fibrin, CD66b, or citrullinated Histone H3 between groups. Based on MSB staining, there was no statistically significant difference regarding the percentage of red blood cells, white blood cells, fibrin, and platelets.ConclusionsOur study found higher concentrations of CRP and vWF in retrieved clots of COVID-19-positive stroke patients compared to COVID-19-negative controls. These findings support the potential role of systemic inflammation as indicated by elevated CRP and endothelial injury as indicated by elevated vWF as precipitating factors in thrombus development in these patients.

Indexed as

COVID-19Cytokine Release SyndromeEndothelium, VascularSARS-CoV-2Thrombotic StrokeAdultAgedAged, 80 and overAntigens, CDCase-Control StudiesCell Adhesion MoleculesC-Reactive ProteinFemaleFibrinogenGPI-Linked ProteinsHistonesAntigens, CDCEACAM8 protein, humanCell Adhesion MoleculesC-Reactive ProteinFibrinogenGPI-Linked ProteinsHistonesInterleukin-6von Willebrand FactorCOVID-19emboliischemic strokemechanism

Identifiers

PMID37769315
PMCPMC12475317

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.