Prevalence and Significance of Impaired Microvascular Tissue Reperfusion Despite Macrovascular Angiographic Reperfusion (No-Reflow)

FC Ng; L Churilov; N Yassi; TJ Kleinig; V Thijs; T Wu; D Shah; H Dewey; G Sharma; P Desmond; B Yan; M Parsons; G Donnan; S Davis; P Mitchell; B Campbell

Journal article

Prevalence and Significance of Impaired Microvascular Tissue Reperfusion Despite Macrovascular Angiographic Reperfusion (No-Reflow)

FC Ng, L Churilov, N Yassi, TJ Kleinig, V Thijs, T Wu, D Shah, H Dewey, G Sharma, P Desmond, B Yan, M Parsons, G Donnan, S Davis, P Mitchell, B Campbell

Neurology | LIPPINCOTT WILLIAMS & WILKINS | Published : 2022

DOI: 10.1212/WNL.0000000000013210

Abstract

Background and ObjectivesThe relevance of impaired microvascular tissue-level reperfusion despite complete upstream macrovascular angiographic reperfusion (no-reflow) in human stroke remains controversial. We investigated the prevalence and clinical-radiologic features of this phenomenon and its associations with outcomes in 3 international randomized controlled thrombectomy trials with prespecified follow-up perfusion imaging.MethodsIn a pooled analysis of the Extending the Time for Thrombolysis in Emergency Neurological Deficits-Intra-Arterial (EXTEND-IA; ClinicalTrials.gov NCT01492725), Tenecteplase Versus Alteplase Before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK; NCT023880..

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University of Melbourne Researchers

Leonid Churilov Author

Nawaf Yassi Author

Vincent Thijs Author

Patricia Desmond Author

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Grants

Awarded by Amgen

Funding Acknowledgements

This study is supported by grants from the National Health and Medical Research Council of Australia (1043242, 1035688, 1113352, 1111972, 1150610), National Heart Foundation of Australia (100,782), State Government of Victoria, and the Australian and New Zealand Association of Neurologists.