Quantitative analysis of toxic metals in plasma and intracranial thrombi in acute ischemic stroke.

BACKGROUND

Circulating toxic metals have been associated with stroke risk, but whether circulating concentrations reflect their distribution within intracranial thrombi remains unclear. We assessed lead, cadmium, aluminum, and chromium in paired plasma and thrombus samples from patients with acute ischemic stroke undergoing mechanical thrombectomy.

METHODS

In this single-center observational study, 35 consecutive patients with large-vessel occlusion treated with mechanical thrombectomy were included. Metal concentrations were measured in paired intracranial thrombi and peripheral plasma samples by inductively coupled plasma mass spectrometry. Paired comparisons and plasma-thrombus correlation analyses were performed.

RESULTS

Metal distribution differed across biological matrices. Aluminum was detected in all thrombi but in only 2/35 plasma samples and was significantly higher in thrombi (p < 0.0001). Cadmium also differed significantly between matrices (p = 0.0038). No significant paired differences were found for lead or chromium. Plasma-thrombus correlations were not significant for any metal.

CONCLUSIONS

In acute ischemic stroke, toxic metal distribution appears matrix-dependent and metal-specific. Circulating concentrations may not reliably reflect thrombus-associated metal levels.