Distinct characteristics of acute ischemic stroke thrombi that impair fibrinolysis

Takeaway

  • Thrombi from acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) have an outer shell that is platelet rich and resistant to tissue-type plasminogen activator (tPA), while the inner core is heterogeneous and susceptible to tPA.

Why this matters

  • The gold standard for AIS recanalization is tPA plus endovascular therapy (EVT), but recanalization is only achieved in 30% of patients with AIS with LVO who undergo tPA.

  • Understanding mechanisms underlying treatment response will lead to the development of novel therapeutic strategies for AIS.