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. 2023 Aug;14(4):446-454.
doi: 10.1007/s12975-022-01053-0. Epub 2022 Jun 27.

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

Xuesong Bai #  1   2 , Fan Yu #  3   4 , Qiuyue Tian  5 , Wei Li  1   6 , Araman Sha  3   4 , Wenbo Cao  1   2 , Yao Feng  1   2 , Bin Yang  1   2 , Yanfei Chen  1   2 , Peng Gao  1   2   7 , Yabing Wang  1   2 , Jian Chen  1 , Adam A Dmytriw  8 , Robert W Regenhardt  8 , Renjie Yang  1   2 , Zhaolin Fu  1   2 , Qingfeng Ma  9 , Jie Lu  10   11 , Liqun Jiao  12   13   14
Affiliations

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

Xuesong Bai et al. Transl Stroke Res. 2023 Aug.

Erratum in

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.

Keywords: CTP; Mechanical thrombectomy; Microvascular tissue reperfusion; Stroke; TOR.

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