Kentaro Deguchi, Hideyuki Ohnishi, Koji Tokunaga, Hiroyuki Ohnishi, Yuji Takasugi, Yosuke Osakada, Ryo Sasaki, Kenji Fukutome, Takayuki Nagase, Yasuyuki Ohta, Ryosuke Maeoka, Susumu Sasada, Ryuta Morihara, Mami Takemoto, Yuko Kawahara, Satoshi Inoue, Yasuki Suruga, Yoshio Omote, Namiko Matsumoto, Kyoichi Watanabe, Kazuki Kobayashi, Nozomi Hishikawa, Koji Abe, Kenkichi Takahashi, Yoshihiro Kuga, Emi Nomura, Koh Tadokoro, and Toru Yamashita
The relationship between stroke etiology and clot pathology remains controversial.We performed histological analysis of clots retrieved from 52 acute ischemic stroke patients using hematoxylin and eosin staining and immunohistochemistry (CD42b and oxidative/hypoxic stress markers). The correlations between clot composition and the stroke etiological group (i.e., cardioembolic, cryptogenic, or large artery atherosclerosis) were assessed.Of the 52 clots analyzed, there were no significant differences in histopathologic composition (e.g., white blood cells, red blood cells, fibrin, and platelets) between the 3 etiological groups (P = .92). By contrast, all large artery atherosclerosis clots showed a localized pattern with the oxidative stress marker 4-hydroxyl-2-nonenal (P.01). From all 52 clots, 4-hydroxyl-2-nonenal expression patterns were localized in 28.8% of clots, diffuse in 57.7% of clots, and no signal in 13.5% of clots.A localized pattern of 4-hydroxyl-2-nonenal staining may be a novel and effective marker for large artery atherosclerosis (sensitivity 100%, specificity 82%).