Ischemic stroke occurs when the blood supply to a region of the brain is compromised, resulting in hypoxia and cell death in the affected regions. This particular type of stroke accounts for over 3/4 of all strokes. Interruption to the blood supply is caused by a thrombus occluding the arterial supply to the region, by formation at the site or embolism from a thrombus elsewhere, commonly of cardiac origin or as a result of atherosclerosis of the large arteries.
Effective treatment of ischemic stroke is by pharmacological thrombolysis; currently limited to rtPA (alteplase and tenecteplase) therapy, or thrombectomy (endovascular removal of the occlusion). This can result in the recanalisation of the under-perfused brain tissues and preservation and restoration of function to a large portion of the affected brain areas. This is crucially important in minimising the overall brain damage to stroke victims, reducing their recovery time and maximising their quality of life after recovery. Treatment, in either case, needs to be performed as soon as possible to be most effective. This project is part of an ongoing large international study in collaboration with stroke centres across Europe. Over 1,000 acute ischemic stroke clots have been collected in the ‘RESTORE’ registry, led by Dr Doyle. Using histology and immunohistochemistry, components from thrombi extracted by thrombectomy can be studied, with an aim to identify important biomarkers in the thrombus.
The aims are to investigate characteristics that could inform decision making processes in relation to diagnostics, treatment plans, outcomes and etiology, refine and specify pharmacological treatments and medical device design for thrombectomy. In this 8-week project, the focus will be on assessing the expression of p-selectin, a marker of activated platelets in the clot, and assessing the impact of thrombolytic treatment and different etiologies on its expression.