Thrombus Composition in Cerebral Infarctions: Study of Its Association With Plasma Biomarkers, Treatment Efficacy, Etiology and Prognosis.

Composition du Thrombus Dans Les Infarctus cérébraux : étude du Lien Avec Avec Des Biomarqueurs Plasmatiques, l'efficacité du Traitement, l'étiologie et le Pronostic.

This study focuses on thrombi collected during mechanical thrombectomy procedures, as well as on plasma biomarkers analyzed concomitantly. The primary objective of the study is to investigate associations and correlations between, on the one hand, the composition of thrombi retrieved during thrombectomy and, on the other hand, plasma biomarkers, treatment response, etiology, and prognosis of ischemic stroke and cerebral venous thrombosis.

The secondary objectives of this study are to precisely characterize the biochemical composition of the thrombi (notably using techniques such as enzyme-linked immunosorbent assay [ELISA] following extraction of proteins contained within the thrombus), their histological structure (using standard histology with hematoxylin-eosin staining and immunohistochemistry), and their biological activity (in particular through in vitro assays assessing resistance to thrombolysis and the endothelial-adhesive or destructive properties of thrombi). Additional secondary objectives include testing new therapeutic methods for the lysis of thrombi collected by mechanical thrombectomy and establishing a link between thrombus transcriptomics and their confirmed etiology, particularly for thrombi initially described as having an embolic appearance and of undetermined etiology.

Inclusion Criteria:

• Patients aged 18 years and older
• Presenting with cerebral infarction secondary to an arterial occlusion responsible for an ischemic stroke, or with cerebral venous thrombosis (CVT) having undergone a mechanical thrombectomy (MT) procedure
• Managed with mechanical thrombectomy
• Provision of free, informed, and explicit consent by the patient or their legal representative/next of kin (emergency inclusion procedure)

Exclusion Criteria:

• Patients under legal protection measures (e.g., guardianship or curatorship)
• Patients for whom the thrombectomy specimen cannot be retrieved or is not suitable for analysis (estimated at approximately 50% of patients undergoing MT)