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Research ArticleNeurointervention

Ischemic Stroke Thrombus Perviousness Is Associated with Distinguishable Proteomic Features and Susceptibility to ADAMTS13-Augmented Thrombolysis

Derrek Schartz, Sajal Medha K. Akkipeddi, Redi Rahmani, Nathaniel Ellens, Clifton Houk, Gurkirat Singh Kohli, Logan Worley, Kevin Welle, Tarun Bhalla, Thomas Mattingly, Craig Morrell and Matthew T. Bender
American Journal of Neuroradiology January 2024, 45 (1) 22-29; DOI: https://doi.org/10.3174/ajnr.A8069
Derrek Schartz
aFrom the Department of Imaging Sciences (D.S., L.W.), University of Rochester Medical Center, Rochester, New York
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Sajal Medha K. Akkipeddi
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Redi Rahmani
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Nathaniel Ellens
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Clifton Houk
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Gurkirat Singh Kohli
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Logan Worley
aFrom the Department of Imaging Sciences (D.S., L.W.), University of Rochester Medical Center, Rochester, New York
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Kevin Welle
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Tarun Bhalla
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Thomas Mattingly
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Craig Morrell
cAab Cardiovascular Research Institute (C.M.), University of Rochester Medical Center, Rochester, New York
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Matthew T. Bender
bDepartment of Neurosurgery (D.S., S.M.K.A., R.R., N.E., C.H., G.S.K., K.W., T.B., T.M., M.T.B.), University of Rochester Medical Center, Rochester, New York
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Figures

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  • FIG 1.
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    FIG 1.

    Sample calculation of thrombus perviousness/permeability on admission NCCT (left) and CTA (right). The image on the left demonstrates NCCT with 3 ROIs placed on the thrombus, with the thrombus attenuation in Hounsfield units calculated as the mean among the ROI values. The image on the right demonstrates a similar thrombus attenuation calculation on CTA. Perviousness was then calculated as the difference in Hounsfield units between CTA and NCCT. Likewise, the perviousness ratio was calculated as the ratio of Hounsfield units of the CTA over NCCT.

  • FIG 2.
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    FIG 2.

    Volcano plot depicting the proteomic landscape of pervious acute ischemic stroke clots. The left side of the graph depicts proteins that are significantly depleted (red), while the right side depicts those that are differentially abundant (green).

  • FIG 3.
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    FIG 3.

    Association between specific protein content and the thrombus perviousness ratio. The relation between increasing perviousness ratio and low-affinity FCGR2A/FcγRIIA (A), SYTL4 (B), TPM3 (C), hemoglobin subunit ζ (D), PYCARD/ASC (E), and dNTPase SAMHD1 (F).

  • FIG 4.
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    FIG 4.

    Thrombus perviousness is associated with differential susceptibility to ADAMTS13-augmented thrombolysis. Ns indicates not significant. *P < .05.

Tables

  • Figures
  • Proteins with the most significant abundance and depletion in highly pervious clots

    Protein Namelog2fcP Value
    40S Ribosomal protein S23–0.690129341.00039
    Glutamine synthetase–1.606714657.00073
    40S Ribosomal protein S2–0.413995286.001
    40S Ribosomal protein S12–0.633724478.001
    60S Ribosomal protein L28–0.519178688.001
    Aldehyde dehydrogenase, mitochondrial–0.593729139.0019
    60S Ribosomal protein L27–0.321892776.0022
    40S Ribosomal protein S8–0.658129234.0022
    Electron transfer flavoprotein-ubiquinone oxidoreductase, mitochondrial–0.348210926.0023
    Vesicle transport through interaction with t-SNAREs homolog 1B–0.540383664.0027
    Immunoglobulin heavy variable 1/OR15-1 (nonfunctional) (fragment)0.85769177.04
    BCL2/adenovirus E1B 19 kDa protein-interacting protein 2.0.3110.630567877.015
    Farnesyl pyrophosphate synthase0.357444057.013
    Tropomyosin α-3 chain.0.26160.333697844.005
    GTPase NRAS.0.17030.316709736.02
    Cullin-4A..0.6360.314913909.04
    V-type proton ATPase subunit G 10.285104241.04
    Protein phosphatase 1 regulatory subunit 70.232882868.04
    Dedicator of cytokinesis protein 100.231574532.03
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American Journal of Neuroradiology: 45 (1)
American Journal of Neuroradiology
Vol. 45, Issue 1
1 Jan 2024
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Cite this article
Derrek Schartz, Sajal Medha K. Akkipeddi, Redi Rahmani, Nathaniel Ellens, Clifton Houk, Gurkirat Singh Kohli, Logan Worley, Kevin Welle, Tarun Bhalla, Thomas Mattingly, Craig Morrell, Matthew T. Bender
Ischemic Stroke Thrombus Perviousness Is Associated with Distinguishable Proteomic Features and Susceptibility to ADAMTS13-Augmented Thrombolysis
American Journal of Neuroradiology Jan 2024, 45 (1) 22-29; DOI: 10.3174/ajnr.A8069

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Stroke Thrombus Perviousness
Derrek Schartz, Sajal Medha K. Akkipeddi, Redi Rahmani, Nathaniel Ellens, Clifton Houk, Gurkirat Singh Kohli, Logan Worley, Kevin Welle, Tarun Bhalla, Thomas Mattingly, Craig Morrell, Matthew T. Bender
American Journal of Neuroradiology Jan 2024, 45 (1) 22-29; DOI: 10.3174/ajnr.A8069
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