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Clinical Significance and Influencing Factors of Microvascular Tissue Reperfusion After Macrovascular Recanalization

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An Author Correction to this article was published on 21 October 2022

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Abstract

The relevance of impaired microvascular tissue reperfusion despite successful macrovascular angiographic reperfusion (no-reflow) in acute ischemic stroke (AIS) remains controversial. In this study, we aimed to investigate the impact of tissue optimal reperfusion (TOR) and its influencing factors. From December 1, 2020 to December 1, 2021, AIS patients with successful recanalization (modified Thrombolysis in Cerebral Infarction score [mTICI] ≥ 2b) after mechanical thrombectomy (MT) were retrospectively reviewed. Computed tomography perfusion was performed before and after MT. Successful reperfusion was assessed by TOR, defined as > 90% reduction of the Tmax > 6 s lesion volumes between baseline and early follow-up perfusion profiles. The impact of TOR on functional outcomes after successful recanalization and influencing factors for TOR were both investigated. Sixty-three patients were included, including 44 cases in the TOR group and 19 cases in the non-TOR group. The TOR group had a higher rate of favorable outcome (aOR 4.366, 95%CI 1.159–16.445, p = 0.030) and NIHSS improvement (aOR 5.089, 95%CI 1.340–19.322, p = 0.017) than the non-TOR group. Multivariable logistic regression showed baseline glucose (OR 0.648, 95%CI 0.492–0.854, p = 0.002) and mTICI 2c/3 (OR 10.984, 95%CI 2.220–54.343, p = 0.003) predicted TOR in model 1; in model 2, postoperative glucose (OR 0.468, 95%CI 0.278–0.787, p = 0.004) and mTICI 2c/3 (OR 9.436, 95%CI 1.889–47.144, p = 0.006) were predictive. TOR was strongly associated with good functional outcomes after successful recanalization of MT. Higher mTICI grade and lower perioperative glucose level may predict microvascular tissue reperfusion.

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The original contributions presented in the study are included in the article/supplementary material; further inquiries can be directed to the corresponding authors.

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Author information

Author notes

  1. Xuesong Bai and Fan Yu contributed equally and are co-first authors.

Authors and Affiliations

  1. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 100053, China

    Xuesong Bai, Wei Li, Wenbo Cao, Yao Feng, Bin Yang, Yanfei Chen, Peng Gao, Yabing Wang, Jian Chen, Renjie Yang, Zhaolin Fu & Liqun Jiao

  2. China International Neuroscience Institute (China-INI), Beijing, 100053, China

    Xuesong Bai, Wenbo Cao, Yao Feng, Bin Yang, Yanfei Chen, Peng Gao, Yabing Wang, Renjie Yang, Zhaolin Fu & Liqun Jiao

  3. Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, China

    Fan Yu, Araman Sha & Jie Lu

  4. Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China

    Fan Yu, Araman Sha & Jie Lu

  5. Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, 100069, China

    Qiuyue Tian

  6. Department of Neurosurgery, Liaocheng Brain Hospital, Liaocheng, 252000, Shandong, China

    Wei Li

  7. Department of Interventional Neuroradiology, Xuanwu Hospital, Capital Medical University, Beijing, China

    Peng Gao & Liqun Jiao

  8. Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA

    Adam A. Dmytriw & Robert W. Regenhardt

  9. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China

    Qingfeng Ma

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  1. Xuesong Bai
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Contributions

XB, FY, JL, and LJ developed the initial idea for this study. XB, FY, JL, and LJ designed the study. XB, FY, WL, AS, WC, ZF, YF, and RY collected the data. QT analyzed the data. BY, YC, PG, YW, JC, JL, and LJ were consulted about clinical issues. XB and FY contributed to the original draft. XB, FY, AA, RR, QM, JL, and LJ were responsible for the revision of the draft. XB and FY contributed equally and are co-first authors. All authors approved the final version of the manuscript before submission.

Corresponding authors

Correspondence to Jie Lu or Liqun Jiao.

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Bai, X., Yu, F., Tian, Q. et al. Clinical Significance and Influencing Factors of Microvascular Tissue Reperfusion After Macrovascular Recanalization. Transl. Stroke Res. 14, 446–454 (2023). https://doi.org/10.1007/s12975-022-01053-0

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