{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T19:24:23Z","timestamp":1789932263211,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Patients with active cancer face an increased risk of ischemic stroke. Also, stroke may be an initial indicator of cancer. In patients with large vessel occlusion (LVO) stroke treated with thrombectomy, analysis of the clot composition may contribute new insights into the pathological connections between these two conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared the content of 64 consecutively retrieved clots from LVO stroke patients with concomitant active cancer and 64 clots from matched\u2010control LVO stroke patients without a history of cancer. Clots were analyzed with respect to histological composition by Martius Scarlet Blue, von Willebrand factor (vWF), citrullinated histone H3 (H3Cit, a biomarker of NETS), CD42b, and CD3 expression by immunohistochemistry. Orbit Image Analysis was used for quantification. Differences between groups were tested using the Mann\u2013Whitney <jats:italic>U<\/jats:italic>\u2010test and Chi\u2010square Test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clots from patients with concomitant cancer had a significantly higher content of vWF (median 26 [IQR13\u201038]% vs. 10 [4\u201318]%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and H3Cit (median 0.11 [IQR0.02\u20130.46]% vs. 0.05 [0.00\u20130.28]% <jats:italic>p<\/jats:italic>\u2009=\u20090.027) than controls. The presence of collagen &gt;1% within the retrieved clots was highly indicative of cancer, occurring in 16\/64 with active cancer and in 3\/64 controls, <jats:italic>p<\/jats:italic>\u2009=\u20090.002. After correction for multiple comparisons, the statistical significance for H3Cit was lost. Red and white blood cells, platelets, fibrin, and expression of CD3 and CD42b did not differ between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clots from LVO patients with concomitant active cancer possess distinct characteristics, indicating an influence of cancer on the innate immune system, fibroblasts, and the vascular endothelium in the formation of LVO clots.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70037","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T10:41:16Z","timestamp":1736160076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clot signature in patients with large vessel occlusion stroke and concomitant active cancer"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9291-3151","authenticated-orcid":false,"given":"Malin","family":"Woock","sequence":"first","affiliation":[{"name":"Department of Neurology Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Clinical Neuroscience, Institute of Neuroscience and Physiology Sahlgrenska Academy at University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanna","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Physiology and Galway Neuroscience Centre, School of Medicine University of Galway  Galway Ireland"},{"name":"C\u00daRAM\u2013SFI Research Centre in Medical Devices University of Galway  Galway Ireland"},{"name":"Institute of Biotechnology and Biomedicine IBB, Autonomous University of Barcelona  Barcelona 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Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Istv\u00e1n","family":"Szikora","sequence":"additional","affiliation":[{"name":"Department of Neurointerventions National Institute of Clinical Neurosciences  Budapest Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-3797","authenticated-orcid":false,"given":"Georgios","family":"Tsivgoulis","sequence":"additional","affiliation":[{"name":"Second Department of Neurology National &amp; Kapodistrian University of Athens, \u201cAttikon\u201d University Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3993-2545","authenticated-orcid":false,"given":"Klearchos","family":"Psychogios","sequence":"additional","affiliation":[{"name":"Stroke Unit Metropolitan Hospital  Piraeus Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Magoufis","sequence":"additional","affiliation":[{"name":"Stroke Unit Metropolitan Hospital  Piraeus Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandros","family":"Rentzos","sequence":"additional","affiliation":[{"name":"Department of Radiology, Section of Diagnostic and Interventional Neuroradiology Sahlgrenska University Hospital  Gothenburg Sweden"},{"name":"Department of Radiology, Institute of Clinical Sciences Sahlgrenska Academy at the University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Doyle","sequence":"additional","affiliation":[{"name":"Department of Physiology and Galway Neuroscience Centre, School of Medicine University of Galway  Galway Ireland"},{"name":"C\u00daRAM\u2013SFI Research Centre in Medical Devices University of Galway  Galway 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