{"id":230619,"date":"2026-02-05T13:16:15","date_gmt":"2026-02-05T19:16:15","guid":{"rendered":"https:\/\/lifeboat.com\/blog\/2026\/02\/hypoperfusion-on-early-mri-despite-successful-thrombectomy-a-prospective-imaging-and-inflammatory-biomarkers-study"},"modified":"2026-02-05T13:16:15","modified_gmt":"2026-02-05T19:16:15","slug":"hypoperfusion-on-early-mri-despite-successful-thrombectomy-a-prospective-imaging-and-inflammatory-biomarkers-study","status":"publish","type":"post","link":"https:\/\/lifeboat.com\/blog\/2026\/02\/hypoperfusion-on-early-mri-despite-successful-thrombectomy-a-prospective-imaging-and-inflammatory-biomarkers-study","title":{"rendered":"Hypoperfusion on Early MRI Despite Successful Thrombectomy: A Prospective Imaging and Inflammatory Biomarkers Study"},"content":{"rendered":"

<\/a><\/p>\n

ISC26 After successful EVT for stroke, early MRI shows residual hypoperfusion in a substantial subset of patients. Perfusion deficits mainly reflected distal emboli and were not associated with inflammatory biomarkers.<\/p>\n

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In acute ischemic stroke (AIS) due to large-vessel occlusion (LVO), endovascular treatment (EVT) achieves over 80% recanalization rates and improves functional outcomes.1<\/a><\/sup> However, nearly half of recanalized patients fail to achieve functional independence,1<\/a><\/sup> a phenomenon termed futile recanalization.2<\/a>,3<\/a><\/sup> Mechanisms of futile recanalization include early extensive infarct core\u2014that is, tissue that is already irreversibly damaged at the time of reperfusion\u2014as well as edema, hemorrhagic transformation, and no-reflow.3<\/a><\/sup> The latter, defined as impaired capillary reperfusion despite angiographic success, has gained increasing attention.4\u201315<\/a><\/sup><\/p>\n

In experimental models, no-reflow occurs early after arterial reopening and is driven by multifactorial microvascular dysfunction.16\u201319<\/a><\/sup> Reported mechanisms include astrocyte and endothelial swelling, pericyte contraction, leukocytes, platelets and erythrocytes aggregation, and the release of inflammatory mediators.20\u201324<\/a><\/sup> Regarding the latter, cytokines and adhesion molecules have been implicated in its pathogenesis in preclinical studies.24<\/a><\/sup> These findings have led to the hypothesis that inflammation may contribute to microvascular perfusion failure after EVT, potentially opening the door to targeted therapeutic interventions.20\u201324<\/a><\/sup> However, this has never been systematically investigated in humans.<\/p>\n

In clinical practice, persistent hypoperfusion on post-EVT computed tomography (CT) perfusion or magnetic resonance perfusion imaging is frequently interpreted as a radiological correlate of no-reflow.4\u201315<\/a><\/sup> Yet this interpretation remains uncertain. First, no direct histological evidence of no-reflow has been demonstrated in human stroke to date. Second, most imaging-based studies on no-reflow have included patients with residual distal emboli,10<\/a>,12<\/a>,25<\/a><\/sup> which cause residual hypoperfusion on a macrovascular level.26<\/a><\/sup> Third, many studies did not exclude confounders, such as perfusion abnormalities caused by carotid stenosis, parenchymal hemorrhage, or reocclusion.14<\/a><\/sup> These limitations may explain the wide variability in the reported prevalence of postthrombectomy hypoperfusion, from 0% to 80%.14<\/a>,25<\/a><\/sup>.<\/p>\n","protected":false},"excerpt":{"rendered":"

ISC26 After successful EVT for stroke, early MRI shows residual hypoperfusion in a substantial subset of patients. Perfusion deficits mainly reflected distal emboli and were not associated with inflammatory biomarkers. In acute ischemic stroke (AIS) due to large-vessel occlusion (LVO), endovascular treatment (EVT) achieves over 80% recanalization rates and improves functional outcomes.1 However, nearly half [\u2026]<\/p>\n","protected":false},"author":662,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-230619","post","type-post","status-publish","format-standard","hentry","category-biotech-medical"],"_links":{"self":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/230619","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/users\/662"}],"replies":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/comments?post=230619"}],"version-history":[{"count":0,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/230619\/revisions"}],"wp:attachment":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/media?parent=230619"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/categories?post=230619"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/tags?post=230619"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}