Document resource
In nearly one-third of acute ischemic stroke (AIS) patients, thrombolytic therapy fails to achieve vascular recanalization, and the reasons for these inconsistencies remain unclear. Recent research has highlighted the unique behavior of fibrin in forming an anomalous amyloid-like structure, termed “fibrinaloid,” that exhibits notable resistance to fibrinolysis. This fibrinaloid form has been documented predominantly in microthrombi, typically in the range of 2–200 μm in diameter, raising questions about the implications for larger thrombi, such as those found in patients experiencing AIS. This retrospective observational analysis investigates whether thrombi retrieved during mechanical thrombectomy (MT) exhibit analogous amyloid characteristics, which could provide new insights into thrombus persistence and resistance to lytics or natural degradation mechanisms.A variety of stains and methods have been used to study thrombus morphology, often to elucidate thrombus origin and structure. However, to our knowledge, specific staining for amyloid in AIS thrombi has not been reported. In this study, we used thioflavin T, a standard amyloid stain, to detect amyloid content within thrombi extracted from patients undergoing thrombectomy.Our findings indicate that amyloid formation is a widespread characteristic of thrombi retrieved from AIS patients, which could contribute to thrombus persistence and resistance to fibrinolytic therapy in ischemic injury. The high amyloid content observed here is particularly relevant for understanding thrombus genesis and persistence, especially in cases where thrombi resist fibrinolysis and contribute to ongoing ischemic injury.alakendu.sekhar@nhs.net