Stroke is a leading cause of death and disability worldwide. Over 1.1 million people in the EU and 15 million people worldwide suffer a stroke each year. The majority (80-85%) of strokes are acute ischemic strokes, caused by blockage of a cerebral vessel by a thrombus or embolus.  The mortality is as high as 40% and over half of those who survive are left with life changing disability. Approval of a thrombolytic drug (tissue plasminogen activator (tPA)) to dissolve stroke-causing blood clots in the late 1990’s led to the first major clinical development in the treatment of acute ischemic stroke. In the last ten years, an endovascular surgical procedure called mechanical thrombectomy has radically changed stroke treatment, quickly becoming a gold-standard intervention to remove the clot at specialist stroke centres.  

Not all clots that cause strokes are the same. The composition of blood clots can vary considerably and significantly influences the outcome for patients treated with thrombolytic and/or mechanical thrombectomy devices.  In collaboration with partners in stroke centres internationally, my research team have developed two of the largest registries of stroke clots in the world, called the RESTORE registry and the CLOTBASE registry. Through our work studying the clots that cause strokes, we aim to improve acute ischemic stroke treatment by advancing medical device design to remove stroke-causing clots optimally.  Additionally, our work aims to discover diagnostic biomarkers that can lead to improved diagnostic tests in the emergency care setting, new therapeutic strategies to dissolve clots safely and to prevent strokes in the future. This talk will give some examples of advancements we have made in this area.