ArticleStroke (Hoboken, N.J.)2024
Is Clot Composition Associated With Cause of Stroke? A Systematic Review and Meta-Analysis.
Article in Stroke (Hoboken, N.J.), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Histological Insights into the Neuroprotective Effects of Antioxidant Peptides and Small Molecules in Cerebral Ischemia.Molecules (Basel, Switzerland) · 2025Pooled it
- Different Long-Term Outcomes According to Thrombus Histology in Patients With Acute Ischemic Stroke.Journal of stroke · 2026Article
- Computed Tomography Radiomic Signatures Associated With Neutrophil Extracellular Trap Enrichment and First-Pass Outcome in Ischemic Stroke Thrombi.Journal of the American Heart Association · 2026Article
- Biomarkers of Cardioembolic Stroke in Thrombus Composition: Diagnostic Value of DNA and Fibrin Content.European journal of neurology · 2026Article
- Clot Composition and Ischemic Stroke Etiology: A Contemporary Narrative Review.Journal of clinical medicine · 2025Review
- Unmet Needs in Acute Ischemic Stroke: Overcoming Recalcitrant Clots.Cardiology in reviewReview
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Prior studies have suggested an association between clot histological composition and cause of stroke. However, the results have been conflicting. Our objective is to provide an updated systematic review and meta-analysis of the association between clot histological composition and cause of stroke for patients who underwent mechanical thrombectomy. Methods: We searched Cochrane Library, Embase, and MEDLINE databases for English language articles reporting clot histology in adult patients who underwent mechanical thrombectomy for acute ischemic stroke between January 2000 and March 2024. Studies included reported on the association between causes of clots and the quantity of red blood cells and fibrin and/or platelets. Random effects meta-analysis was used. Results: A total of 448 records were identified. Of these, 25 studies were included in the qualitative synthesis, and 17 contained data in a format suitable for quantitative review. A total of 1656 patients had continuous data on clot composition and its association with cause of stroke. The pooled mean percentage difference between the cardioembolic group and the large artery atherosclerosis /noncardioembolic group was -10.3% (95% CI -16.3% to -4.4%) for red blood cells and +9.9% (95% CI +4.5% to +15.4%) for fibrin and/or platelets. Only 7 studies reported on overall white blood cells quantity. Of these, the pooled percentage difference of white blood cells between the cardioembolic group and the large artery atherosclerosis/non-cardioembolic group was +1.1% (95% CI +0.3% to +1.9%). Conclusion: Our results suggest that cardioembolic clots have higher fibrin and/or platelets and lower red blood cells compared with large artery atherosclerosis/noncardioembolic clots. However, these differences are unlikely to be of clinical utility in differentiating cause of stroke. Future studies would benefit from more rigorous analysis of clot constituents beyond cellular composition.
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