# Comprehensive immunological profiling of acute ischemic stroke during mechanical thrombectomy: myeloid cell activation and molecular signatures in blood and thrombus

## TL;DR

This study aims to understand immune responses in stroke patients by analyzing blood and thrombus samples during mechanical thrombectomy.

## Contribution

The study introduces a multi-compartment immunological and molecular profiling approach in acute ischemic stroke.

## Key findings

- Immune profiles from arterial blood, peripheral blood, and thrombus will be compared.
- Associations between immune markers and clinical outcomes will be evaluated.
- Integration of immune and clinical data may reveal predictive biomarkers for stroke recovery.

## Abstract

Acute ischemic stroke (AIS) induces a complex local and systemic inflammatory response; however, most studies rely solely on peripheral blood, providing an incomplete view of immune activity at the occlusion site and within the thrombus.

To characterize immune activation and transcriptomic signatures of myeloid cells across three compartments—arterial blood at the occlusion site, peripheral blood, and thrombus—and to evaluate their associations with radiological and clinical outcomes following mechanical thrombectomy.

This prospective, single-center study will include AIS patients treated with mechanical thrombectomy. Matched arterial, peripheral, and thrombus samples will undergo spectral flow cytometry, cytokine profiling, cell-free DNA (cfDNA) quantification, microscopy, and RNA sequencing. Immune and molecular readouts will be correlated with clinical scores (NIHSS, mRS), imaging markers (e.g., hyperdense middle cerebral artery sign [HMCAS]), and procedural outcomes (TICI score, number of passes).

Integrating local and systemic immune profiles with clinical and radiological parameters may identify biomarkers predictive of thrombectomy efficacy and functional recovery, thereby supporting precision-medicine approaches in AIS.

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