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Do the blood vessels in our brain "spit out" clots?

Henry I. Bussey, Pharm.D.
September, 2010

Even though the study was performed in animals, Lam and colleagues1 reported in Nature a very interesting finding that there is a process by which some blood vessels in the brain can "absorb" blood clots into the wall of the blood vessel and then pass the clot on through the blood vessel wall and eject it into the perivascular space. In an editorial in the New England Journal of Medicine2 discussing this study, the authors of the editorial point out that this process apparently takes days, rather than hours, and that the ability of the blood vessels to process clots in this fashion tends to decline with age. Obviously, numerous questions remain such as what triggers this process? What is the impact of the clot once it exits the blood vessel? How are such extravascular clots cleared or eliminated? Can measure be implemented to help blood vessels retain this ability? Does the same process occur in the human brain and, if so, does it occur in all regions of the brain? Perhaps further research in this area will provide new ways of treating and/or preventing or minimizing the impact of some strokes.

References

  1. Lam CK Yoo T, Hiner B, Liu Z, Gritzendler J. Embolus extravasation is an alternative mechanism for cerebral microvascular recanalization. Nature 2010; 465:478-82.
  2. del Zoppo GJ, Hawkins BT. Throwing out the thromboemboli. The New England Journal of Medicine 2010; 363:1282-1284.
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