This is an observational, prospective and retrospective, single-center study of thrombotic material and blood samples obtained from patients undergoing mechanical endovascular thrombectomy for ischemic stroke caused by large vessel occlusion or stenosis.

The overarching aim of this study is to advance the understanding of the pathogenesis of cerebral ischemia and to support the development of novel therapeutic strategies for cerebrovascular disease. Specifically, the research seeks to elucidate the pathophysiological mechanisms involved in thrombus formation and stabilization that lead to ischemic events, identify thrombus compositions associated with distinct stroke etiologies, and determine features predictive of resistance to current intravenous thrombolytic therapies. In addition, the study aims to discover novel therapeutic targets and to identify circulating blood biomarkers indicative of an elevated risk of thrombosis.

Inclusion Criteria:

• Age ≥ 18 years.
• Presentation to the emergency department with symptoms and/or signs suggestive of:
• An acute cerebrovascular event
• Stroke mimics
• Stroke-related risk factors (e.g., atrial fibrillation, endocarditis, significant internal carotid stenosis, neoplasms, systemic infections)
• Undergoing one of the following treatments:
• Mechanical thrombectomy
• Intravenous thrombolysis
• Standard medical therapy
• Provision of informed consent, either:
• Directly from the conscious patient
• Via appropriate procedures for unconscious patients

Exclusion Criteria:

• Pregnancy or breastfeeding
• Presence of a known autoimmune disease that could interfere with the interpretation of biomarker analyses

The study focuses on adult patients experiencing ischemic stroke presenting at the emergency department/ neurology department of the Hospital of inclusion due to a large vessel occlusion and/or stenosis, undergoing standard diagnostic and therapeutic procedures involving mechanical thrombectomy, thrombolysis or standard medical care.