Pathophysiological mechanisms of futile recanalization following endovascular therapy for acute ischemic stroke due to large vessel occlusion and potential targeted therapeutic strategy
10.3760/cma.j.cn113694-20220327-00247
- VernacularTitle:急性缺血性脑卒中血管内治疗无效再通的病理生理机制和潜在治疗策略
- Author:
Gang DENG
1
;
Chuan QIN
;
Daishi TIAN
Author Information
1. 华中科技大学同济医学院附属同济医院神经内科，湖北430030
- Keywords:
Stroke;
Brain ischemia;
Arterial occlusive diseases;
Collateral circulation;
No-reflow phenomenon
- From:
Chinese Journal of Neurology
2022;55(12):1423-1430
- CountryChina
- Language:Chinese
-
Abstract:
Endovascular therapy is the standard treatment for acute ischemic stroke due to large vessel occlusion. However, an increasing number of studies have demonstrated that about half of patients had poor functional recovery despite successful recanalization, namely futile recanalization. Previous studies suggested that tissue no-reflow (lack of reperfusion despite recanalized large vessel), early re-occlusion, poor collateral status, hemorrhagic transformation, impaired cerebral autoregulation and large hypoperfusion volume may all contribute to futile recanalization. Targeted treatment strategies for these mechanisms have been attempted in pre-clinical researches but failed to translate into clinical practices. This review aimed to summarize the mechanisms of futile recanalization and potential targeted treatment strategies, particularly focus on the no-reflow phenomenon and its mechanisms, clinical evaluation, and treatment approaches, hoping to promote translational research and improve the status of stroke treatment.
