Clinically Ineffective Reperfusion After Endovascular Therapy in Acute Ischemic Stroke.
Ximing NieXinyi LengZhongrong MiaoMarc FisherLi-Ping LiuPublished in: Stroke (2022)
Endovascular treatment is a highly effective therapy for acute ischemic stroke due to large vessel occlusion. However, in clinical practice, nearly half of the patients do not have favorable outcomes despite successful recanalization of the occluded artery. This unfavorable outcome can be defined as having clinically ineffective reperfusion. The objective of the review is to describe clinically ineffective reperfusion after endovascular therapy and its underlying risk factors and mechanisms, including initial tissue damage, cerebral edema, the no-reflow phenomenon, reperfusion injury, procedural features, and variations in postprocedural management. Further research is needed to more accurately identify patients at a high risk of clinically ineffective reperfusion after endovascular therapy and to improve individualized periprocedural management strategies, to increase the chance of achieving favorable clinical outcomes.
Keyphrases
- acute ischemic stroke
- cerebral ischemia
- acute myocardial infarction
- endovascular treatment
- risk factors
- subarachnoid hemorrhage
- clinical practice
- brain injury
- newly diagnosed
- blood brain barrier
- ejection fraction
- percutaneous coronary intervention
- prognostic factors
- mesenchymal stem cells
- adipose tissue
- stem cells
- coronary artery disease
- patient reported outcomes
- acute coronary syndrome
- insulin resistance
- catheter ablation