The Blood And Clot Thrombectomy Registry And Collaboration (BACTRAC) protocol: novel method for evaluating human stroke.
BACKGROUND
Ischemic stroke research faces difficulties in translating pathology between animal models and human patients to develop treatments. Mechanical thrombectomy, for the first time, offers a momentary window into the changes occurring in ischemia. We developed a tissue banking protocol to capture intracranial thrombi and the blood immediately proximal and distal to it.


OBJECTIVE
To develop and share a reproducible protocol to bank these specimens for future analysis.


METHODS
We established a protocol approved by the institutional review board for tissue processing during thrombectomy (www.clinicaltrials.gov NCT03153683). The protocol was a joint clinical/basic science effort among multiple laboratories and the NeuroInterventional Radiology service line. We constructed a workspace in the angiography suite, and developed a step-by-step process for specimen retrieval and processing.


RESULTS
Our protocol successfully yielded samples for analysis in all but one case. In our preliminary dataset, the process produced adequate amounts of tissue from distal blood, proximal blood, and thrombi for gene expression and proteomics analyses. We describe the tissue banking protocol, and highlight training protocols and mechanics of on-call research staffing. In addition, preliminary integrity analyses demonstrated high-quality yields for RNA and protein.


CONCLUSIONS
We have developed a novel tissue banking protocol using mechanical thrombectomy to capture thrombus along with arterial blood proximal and distal to it. The protocol provides high-quality specimens, facilitating analysis of the initial molecular response to ischemic stroke in the human condition for the first time. This approach will permit reverse translation to animal models for treatment development.
['Fraser|Justin F|JF|http://orcid.org/0000-0002-5980-3989', 'Collier|Lisa A|LA|', 'Gorman|Amy A|AA|', 'Martha|Sarah R|SR|', 'Salmeron|Kathleen E|KE|', 'Trout|Amanda L|AL|', 'Edwards|Danielle N|DN|', 'Davis|Stephanie M|SM|', 'Lukins|Douglas E|DE|http://orcid.org/0000-0002-9912-4905', 'Alhajeri|Abdulnasser|A|', 'Grupke|Stephen|S|', 'Roberts|Jill M|JM|', 'Bix|Gregory J|GJ|', 'Pennypacker|Keith R|KR|']
D000368:Aged D000792:Angiography D000818:Animals D002545:Brain Ischemia D005260:Female D006801:Humans D000070516:Intersectoral Collaboration D020767:Intracranial Thrombosis D008297:Male D008875:Middle Aged D012042:Registries D020521:Stroke D017131:Thrombectomy D013927:Thrombosis D014015:Tissue Banks D016896:Treatment Outcome
thrombectomy stroke inflammatory response technique