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The authors evaluated the potential relationship between thrombus histology and clot stability in 85 patients with anterior circulation stroke treated with thrombectomy. The number and location of emboli after retrieving the primary thrombus, the number of maneuvers, and TICI scores were evaluated. H&E and neutrophil elastase staining of retrieved clots was performed. An inverse correlation between maneuvers required for thrombus retrieval and the number of distal and intermediate emboli was observed. Younger patients were at higher risk for periprocedural thrombus fragmentation. Bridging thrombolysis tended to be associated with fewer maneuvers but more emboli. They conclude that younger age, easy-to-retrieve thrombi, and bridging thrombolysis may be risk factors for periprocedural thrombus fragmentation. Higher neutrophil levels in the thrombus tissue were related to an increased risk of periprocedural thrombus fragmentation.