CC BY-NC-ND 4.0 · Thromb Haemost 2022; 122(04): 623-632
DOI: 10.1055/a-1544-5431
Stroke, Systemic or Venous Thromboembolism

Circulating Cytokines and Growth Factors in Acute Cerebral Large Vessel Occlusion—Association with Success of Endovascular Treatment

1   Department of Neurology, Hannover Medical School, Hannover, Germany
Christopher Werlein
2   Institute of Pathology, Hannover Medical School, Hannover, Germany
Nicole Blume
1   Department of Neurology, Hannover Medical School, Hannover, Germany
Omar Abu-Fares
3   Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
Friedrich Götz
3   Institute of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany
Maria M. Gabriel
1   Department of Neurology, Hannover Medical School, Hannover, Germany
Johanna Ernst
1   Department of Neurology, Hannover Medical School, Hannover, Germany
Andrei Leotescu
1   Department of Neurology, Hannover Medical School, Hannover, Germany
Hans Worthmann
1   Department of Neurology, Hannover Medical School, Hannover, Germany
Mark P. Kühnel
2   Institute of Pathology, Hannover Medical School, Hannover, Germany
4   Member of the German Center for Lung Research (DZL), Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
Danny D. Jonigk
2   Institute of Pathology, Hannover Medical School, Hannover, Germany
4   Member of the German Center for Lung Research (DZL), Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
Christine S. Falk*
5   Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
Karin Weissenborn*
1   Department of Neurology, Hannover Medical School, Hannover, Germany
Ramona Schuppner*
1   Department of Neurology, Hannover Medical School, Hannover, Germany
› Author Affiliations
Funding This study was supported by PRACTIS—Clinician Scientist Program of Hannover Medical School, funded by the German Research Foundation (grant number: DFG, ME 3696/3–1) (G.M.G.) and by the Clinical Research Group (Klinische Forschergruppe [KFO]) 311 of the German Research Foundation (DFG) (C.W., M.P.K., and D.D.J).


Mechanical thrombectomy (MT) is a highly efficient treatment in patients with acute ischemic stroke due to large vessel occlusion (LVO). However, in a relevant proportion of LVO, no sufficient recanalization can be achieved. The composition of cerebral thrombi is highly heterogeneous and may constitute a relevant factor for insufficient reperfusion. We hypothesized that circulating cytokines and growth factors involved in thromboinflammation and platelet activation may be associated with reperfusion status and thrombus composition in patients undergoing MT. An according biomarker panel was measured in plasma specimens taken prior to MT and at a 7-day follow-up. The reperfusion status was categorized into sufficient or insufficient. The composition of retrieved thrombi was histologically analyzed. Differences of baseline biomarker concentrations between insufficient and sufficient reperfusions were highest for interferon (IFN)-γ, epidermal growth factor, platelet-derived growth factor (PDGF)-AB/BB, and IFN-γ-induced protein 10 (IP-10/CXCL10). After applying correction for multiple comparisons and logistic regression analysis adjusting for stroke etiology, intravenous thrombolysis, and vascular risk factors, PDGF-AB/BB was identified as an independent predictor of reperfusion status (odds ratio: 0.403; 95% confidence interval: 0.199–0.819). Histological analysis revealed that the majority of thrombi had a mixed composition. In conclusion, this study provides the first evidence that cytokines and growth factors are potential effectors in patients undergoing MT for the treatment of acute ischemic stroke.

* These authors contributed equally to this work.

Supplementary Material

Publication History

Received: 21 April 2021

Accepted: 01 July 2021

Accepted Manuscript online:
05 July 2021

Article published online:
05 August 2021

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