{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:38Z","timestamp":1787016998164,"version":"build-2736575974"},"reference-count":18,"publisher":"BMJ","issue":"6","funder":[{"name":"National Institute of Health","award":["R01 NS105853"],"award-info":[{"award-number":["R01 NS105853"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2021,1,7]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association of carotid webs (CaW) and ischemic stroke is being increasingly recognized. Data on the histologic clot architecture in strokes caused by CaW has not been previously described. Understanding thrombi histopathology may provide insight into the pathophysiology of CaW-related strokes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This case series presents three patients with acute ischemic stroke thought to be caused by ipsilateral CaW. Thromboemboli were retrieved from the middle cerebral artery (MCA) by mechanical thrombectomy and histologic analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three patients aged between 41 and 55 years with few to no vascular risk factors presented with symptoms concerning for an acute MCA territory infarction (National Institutes of Health Stroke Scale (NIHSS) range 10\u201317). Non-contrast computed tomography (CT) Alberta Stroke Program Early CT Score (ASPECTS) range was 7\u20138 and all patients had hyperdense vessel sign. Initial CT angiogram was concerning for CaW with no superimposed thrombus, later confirmed with conventional angiography. All patients underwent thrombectomy with full reperfusion. Comprehensive stroke workup failed to reveal other etiologies besides ipsilateral CaW. The histopathologic appearance was of typical fresh mixed thrombi. Qualitative thrombus composition analysis of clot from Case #1 yielded 42.5% fibrin, 50.0% red blood cells (RBC), and 7.5% white blood cells (WBC); Case #2 yielded 46.9% fibrin, 43.4% RBC, and 9.7% WBC; and Case #3 yielded 61.5% fibrin, 31.8% RBC, and 6.7% WBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The clot composition of large vessel occlusion strokes from CaW is comparable to the histopathology of previously reported clots from other stroke etiologies. Advanced staining techniques may aid in further characterizing the thrombi of this poorly understood condition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/neurintsurg-2020-017112","type":"journal-article","created":{"date-parts":[[2021,1,29]],"date-time":"2021-01-29T13:28:52Z","timestamp":1611926932000},"page":"530-533","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Clot composition in retrieved thrombi after mechanical thrombectomy in strokes due to carotid web"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-3229","authenticated-orcid":false,"given":"Sitara","family":"Koneru","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul G","family":"Nogueira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ehizele","family":"Osehobo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela","family":"Oprea-Ilies","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8103-1930","authenticated-orcid":false,"given":"Alhamza R","family":"Al-Bayati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5271-5524","authenticated-orcid":false,"given":"Waleed","family":"Brinjikji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4051-6450","authenticated-orcid":false,"given":"Daying","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diogo C","family":"Haussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"2024120315553588000_13.6.530.1","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1001\/jamaneurol.2018.3366","article-title":"Current understanding and gaps in research of carotid webs in ischemic strokes: a review","volume":"76","author":"Kim","year":"2019","journal-title":"JAMA Neurol"},{"key":"2024120315553588000_13.6.530.2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019020"},{"key":"2024120315553588000_13.6.530.3","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003464"},{"key":"2024120315553588000_13.6.530.4","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007313"},{"key":"2024120315553588000_13.6.530.5","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.52.4.883"},{"key":"2024120315553588000_13.6.530.6","doi-asserted-by":"crossref","unstructured":"Ozaki D , Endo T , Suzuki H . Carotid web leads to new thrombus formation: computational fluid dynamic analysis coupled with histological evidence [Epub ahead of print 10 Mar 2020]. Acta Neurochir 2020.","DOI":"10.1007\/s00701-020-04272-2"},{"key":"2024120315553588000_13.6.530.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4431"},{"key":"2024120315553588000_13.6.530.8","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-015387"},{"key":"2024120315553588000_13.6.530.9","doi-asserted-by":"publisher","DOI":"10.5853\/jos.2018.00192"},{"key":"2024120315553588000_13.6.530.10","article-title":"Hyperdense vessel sign as a potential guide for the choice of stent retriever versus contact aspiration as first-line thrombectomy strategy","author":"Mohammaden","year":"2020","journal-title":"J Neurointerv Surg"},{"key":"2024120315553588000_13.6.530.11","doi-asserted-by":"crossref","first-page":"1907","DOI":"10.1161\/STROKEAHA.118.024543","article-title":"Platelet-rich emboli in cerebral large vessel occlusion are associated with a large artery atherosclerosis source","volume":"50","author":"Fitzgerald","year":"2019","journal-title":"Stroke"},{"key":"2024120315553588000_13.6.530.12","doi-asserted-by":"publisher","DOI":"10.23736\/S0390-5616.18.04629-5"},{"key":"2024120315553588000_13.6.530.13","doi-asserted-by":"publisher","DOI":"10.1177\/1747493017709671"},{"key":"2024120315553588000_13.6.530.14","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.605576"},{"key":"2024120315553588000_13.6.530.15","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000230307.03438.94"},{"key":"2024120315553588000_13.6.530.16","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012391"},{"key":"2024120315553588000_13.6.530.17","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012721"},{"key":"2024120315553588000_13.6.530.18","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2019-014979"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2020-017112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T11:23:54Z","timestamp":1733397834000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2020-017112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,29]]},"references-count":18,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,5,13]]},"published-print":{"date-parts":[[2021,6]]}},"alternative-id":["10.1136\/neurintsurg-2020-017112"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2020-017112","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,29]]}}}