{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T20:28:41Z","timestamp":1769113721860,"version":"3.49.0"},"reference-count":21,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T00:00:00Z","timestamp":1471910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>We explored whether clot density in middle cerebral artery (MCA) occlusion is related to clinical variables, stroke etiology, blood constituents, and prestroke medication. We performed a retrospective chart review of patients with acute ischemic stroke of the anterior circulation admitted to two Central European stroke centers. The acquisition of non-contrast enhanced CT (NECT) and CT angiography (CTA) within 4.5 h of symptom onset was obligatory. We assessed the site of MCA occlusion as well as density, area, and length of the clot in 150 patients. The Hounsfield unit values for the clot were divided with contralateral MCA segment to yield relative Hounsfield Unit ratio (rHU). The site of the vessel occlusion (M1 vs. M2) and antiplatelet usage, but not stroke etiology, significantly influenced rHU. We found an inverse correlation of rHU with erythrocyte count (p &lt; 0.001). The multivariate analysis revealed that a higher rHU (i.e., clot being more hyperdense) was more likely with the use of antiplatelets (OR 4.24, CI 1.10\u201316.31, p = 0.036). Erythrocyte (OR 0.18, CI 0.05\u20130.55, p = 0.003), and thrombocyte counts (OR 0.99, CI 0.98\u20130.99, p = 0.029) were associated with odds for more hypodense clots (lower rHU). Our study disclosed that antiplatelet therapy impacts the composition of intracranial clots of the anterior circulation.<\/jats:p>","DOI":"10.3390\/ijms17091382","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T10:18:55Z","timestamp":1471947535000},"page":"1382","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke"],"prefix":"10.3390","volume":"17","author":[{"given":"Slaven","family":"Pikija","sequence":"first","affiliation":[{"name":"Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg 5020, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jozef","family":"Magdic","sequence":"additional","affiliation":[{"name":"Department of Neurology, Univerzitetni Klini\u010dni Center, Maribor 2000, Slovenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Lukic","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, General Hospital Varazdin, Varazdin 42000, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catharina","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg 5020, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Mutzenbach","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg 5020, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"McCoy","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg 5020, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann","family":"Sellner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg 5020, Austria"},{"name":"Department of Neurology, Klinikum rechts der Isar, Technische Universit\u00e4t M\u00fcnchen, M\u00fcnchen 81675, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2016,8,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1161\/STROKEAHA.110.605576","article-title":"CT and MRI early vessel signs reflect clot composition in acute stroke","volume":"42","author":"Liebeskind","year":"2011","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1161\/01.CIR.79.4.920","article-title":"Differential sensitivity of erythrocyte-rich and platelet-rich arterial thrombi to lysis with recombinant tissue-type plasminogen activator. A possible explanation for resistance to coronary thrombolysis","volume":"79","author":"Jang","year":"1989","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1161\/ATVBAHA.109.183707","article-title":"Effects of aspirin on clot structure and fibrinolysis using a novel in vitro cellular system","volume":"29","author":"Ajjan","year":"2009","journal-title":"Arterioscler. Thromb. Vasc. Boil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.thromres.2005.02.007","article-title":"Marked increase of fibrin gel permeability with very low dose ASA treatment","volume":"116","author":"Antovic","year":"2005","journal-title":"Thromb. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00062-014-0347-x","article-title":"The impact of histological clot composition in embolic stroke","volume":"26","author":"Schubert","year":"2016","journal-title":"Clin. Neuroradiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1177\/1756285615573690","article-title":"Prothrombotic risk factors and antithrombotic therapy in children with ischemic stroke","volume":"8","author":"Eltayeb","year":"2015","journal-title":"Ther. Adv. Neurol. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"298","DOI":"10.3390\/ijms17030298","article-title":"Immunohistochemical analysis of cerebral thrombi retrieved by mechanical thrombectomy from patients with acute ischemic stroke","volume":"17","author":"Schuhmann","year":"2016","journal-title":"Int. J. Mol. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3834","DOI":"10.1161\/STROKEAHA.109.561787","article-title":"Significance of large vessel intracranial occlusion causing acute ischemic stroke and TIA","volume":"40","author":"Smith","year":"2009","journal-title":"Stroke"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2086","DOI":"10.1161\/01.STR.0000230307.03438.94","article-title":"Analysis of thrombi retrieved from cerebral arteries of patients with acute ischemic stroke","volume":"37","author":"Marder","year":"2006","journal-title":"Stroke"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1161\/STROKEAHA.112.674127","article-title":"Density of thrombus on admission CT predicts revascularization efficacy in large vessel occlusion acute ischemic stroke","volume":"44","author":"Moftakhar","year":"2013","journal-title":"Stroke"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Niesten, J.M., van der Schaaf, I.C., van Dam, L., Vink, A., Vos, J.A., Schonewille, W.J., de Bruin, P.C., Mali, W.P., and Velthuis, B.K. (2014). Histopathologic composition of cerebral thrombi of acute stroke patients is correlated with stroke subtype and thrombus attenuation. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0088882"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.atherosclerosis.2014.10.020","article-title":"Coronary thrombus composition: Links with inflammation, platelet and endothelial markers","volume":"237","author":"Sadowski","year":"2014","journal-title":"Atherosclerosis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/j.jacc.2010.09.077","article-title":"Composition of coronary thrombus in acute myocardial infarction","volume":"57","author":"Silvain","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1111\/j.1747-4949.2009.00331.x","article-title":"Pre admission antithrombotics are associated with improved outcomes following ischaemic stroke: A cohort from the registry of the Canadian stroke network","volume":"4","author":"Dowlatshahi","year":"2009","journal-title":"Int. J. Stroke"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1017\/cjn.2015.291","article-title":"Thrombus characteristics are related to collaterals and angioarchitecture in acute stroke","volume":"42","author":"Qazi","year":"2015","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.neurad.2014.01.124","article-title":"Thrombus composition in acute ischemic stroke: A histopathological study of thrombus extracted by endovascular retrieval","volume":"42","author":"Simons","year":"2015","journal-title":"J. Neuroradiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.thromres.2015.02.004","article-title":"Ultrastructure and composition of thrombi in coronary and peripheral artery disease: Correlations with clinical and laboratory findings","volume":"135","author":"Kovacs","year":"2015","journal-title":"Thromb. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1007\/s00234-013-1217-y","article-title":"Relationship between thrombus attenuation and different stroke subtypes","volume":"55","author":"Niesten","year":"2013","journal-title":"Neuroradiology"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Goyal, M., Menon, B.K., Krings, T., Patil, S., Qazi, E., McTaggart, R.A., Almekhlafi, M.A., Jehan, R., Saver, J., and Jayaraman, M.V. (2016). What constitutes the M1 segment of the middle cerebral artery?. J. Neurointerv. Surg.","DOI":"10.1136\/neurintsurg-2015-012191"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1159\/000443745","article-title":"Treatment with clopidogrel prior to acute non-cardioembolic ischemic stroke attenuates stroke severity","volume":"41","author":"Tziomalos","year":"2016","journal-title":"Cerebrovasc. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1111\/ijcp.12804","article-title":"Effect of prestroke antiplatelets use on first-ever ischaemic stroke severity and early outcome","volume":"70","author":"Bembenek","year":"2016","journal-title":"Int. J. Clin. 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