Lost in Translation: Gaps in Multidimensional Assessment Undermine the Role of Clot Histology in Thrombectomy-An Expert Roadmap and Meta-Analytic Review.

Qualitative synthesis revealed that red blood cell-rich clots are consistently associated with higher rates of successful reperfusion, first-pass effect, fewer passes, and shorter procedure times.

Conversely, F/P-rich and longer clots were linked to lower reperfusion rates and increased distal embolization.

F/P-rich clots achieving TICI ≥2b had significantly lower mean content than those failing (MD: -9.02%; 95% CI: -16.72% to -1.33%).

Additionally, structural heterogeneity was identified as an independent predictor of reduced first-pass effect.