Skip to content
DraconiticResearch
Search Sources API
203,203 studies31 sourcesUpdated 15 min ago
Peer-reviewedCC BY-NC-NDJournal of the American Heart Association

Persistent Hypoperfusion on Post‐Recanalization Digital Subtraction Angiography Perfusion Maps in Anterior Circulation Large Vessel Occlusion

  • Siyuan Li1,2
  • Wenhao Yang3
  • Shaoshuai Wang4
  • Jiangshan Deng5
  • Jie Song6
  • Hanyu Shao7
  • Youmin Wu7
  • Cuiling Qin1,2
  • Zhijiao He1,2
  • Xinru Wang1,2
  • Anqi Zhang1,2
  • Nan Cao1,2
5 more authors
  • Lan Hong1,2
  • Yifeng Ling1,2
  • Feng Wang3
  • Qiang Dong1,2
  • Xin Cheng1,2
7 affiliations
  1. 1National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University
  2. 2Fudan University
  3. 3Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine
  4. 4The First Hospital of Shanxi Medical University
  5. 5Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine
  6. 6Renesas Electronics
  7. 7Shanghai Chentianqiao Research Institute for Brain Health
Open at sourceDOICite

Abstract

Background Despite high recanalization rates with endovascular thrombectomy for large vessel occlusion stroke, a large proportion of patients remain disabled. This study aims to investigate the clinical impact of persistent hypoperfusion that was detected immediately after recanalization. Methods In this multicenter retrospective study of patients with large vessel occlusion with near‐complete or complete recanalization, perfusion maps were generated from post‐recanalization digital subtraction angiography. Focal hypoperfusion within the ischemic territory was detected and categorized as regional or cortical according to spatial distribution. The primary outcome was 90‐day functional independence (modified Rankin Scale 0 to 2). The associations of no‐reflow and outcomes were examined by multivariable logistic regression. Results Among 375 patients (median age 69 [interquartile range 57–77] years; 67.5% men), persistent hypoperfusion was detected in 29.6% of patients. Patients with hypoperfusion had higher baseline National Institutes of Health Stroke Scale (median 14 versus 12, P =0.076) and more thrombectomy passes ( P =0.021). The presence of persistent hypoperfusion was strongly associated with reduced functional independence (adjusted odds ratio [aOR]=0.23, 95% CI 0.13–0.39, P <0.001), higher rates of hemorrhagic transformation (aOR=1.88, 95% CI 1.14–3.11; P =0.013) and symptomatic intracranial hemorrhage (aOR=2.95, 95% CI 1.20–7.23; P =0.018). Quantitative analysis revealed minimum regional cerebral blood flow as a key factor of functional outcome (aOR=1.67, 95% CI 1.07–2.60; P =0.023). There is no significant agreement with 24‐hour computed tomography perfusion‐defined hypoperfusion (κ=0.106, P =0.524). Conclusions Persistent hypoperfusion could be detected immediately post‐recanalization in one‐third of successfully treated large vessel occlusion strokes. The adverse impact to functional outcome highlights its potential as an intraprocedural biomarker for future adjunctive therapies.

Related

  1. Endovascular Recanalization of Non-Acute Vertebrobasilar Occlusion in Progressive Posterior Circulation Ischemia: A Case Report
    Gamaliel Wibowo Soetanto, Elvan Wiyarta
    Neurology internationalPeer-reviewedCC BYFull textGeneral medicineEurope PMC
  2. Association Between Hypoperfusion Intensity Ratio and Outcomes After Endovascular Thrombectomy in Posterior Circulation Stroke: A Retrospective Study
    Ming Mo, Chun Rong Tao, Chun Yu Yu +2
    Stroke (Hoboken, N.J.)Peer-reviewedCC BY-NCFull textEpidemiology & public healthEurope PMCEurope PMCPMC
  3. Persistent tissue hypoperfusion improves risk stratification beyond vasopressor dose in refractory septic shock: a secondary analysis of the ANDROMEDA-SHOCK-2 trial
    Eduardo Kattan, Gustavo A. Ospina-Tascón, Nicolas Orozco +125
    Intensive Care MedicinePeer-reviewedLicence not stated2 citedEpidemiology & public healthHAL
  4. Photon-counting CT-angiography in comparison to digital subtraction angiography and MR-angiography for assessing intra-aneurysmal flow disrupting devices
    Frederic De Beukelaer, Laura L. Wuyts, Martin Wiesmann +3
    Acta Neurologica BelgicaPeer-reviewedCC BY 4.0Full textGeneral medicinePMC
  5. PRISM: Phase-Resolved Isotropic Subtraction Mapping for Automated Multi-Phase CT Digital Subtraction Angiography
    R. Rodriguez, R. Ramirez, H. Rathore
    medRxivPreprintCC BY-NC-NDFull textMedical imaging & radiologymedRxiv

Cite

BibTeXRIS
BibTeX
@article{li2026persistent,
  title = {{Persistent Hypoperfusion on Post‐Recanalization Digital Subtraction Angiography Perfusion Maps in Anterior Circulation Large Vessel Occlusion}},
  author = {Siyuan Li and Wenhao Yang and Shaoshuai Wang and Jiangshan Deng and Jie Song and Hanyu Shao and Youmin Wu and Cuiling Qin and Zhijiao He and Xinru Wang and Anqi Zhang and Nan Cao and Lan Hong and Yifeng Ling and Feng Wang and Qiang Dong and Xin Cheng},
  journal = {Journal of the American Heart Association},
  year = {2026},
  month = oct,
  doi = {10.1161/jaha.125.048868},
  url = {https://www.ahajournals.org/doi/10.1161/JAHA.125.048868},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Persistent Hypoperfusion on Post‐Recanalization Digital Subtraction Angiography Perfusion Maps in Anterior Circulation Large Vessel Occlusion
AU  - Siyuan Li
AU  - Wenhao Yang
AU  - Shaoshuai Wang
AU  - Jiangshan Deng
AU  - Jie Song
AU  - Hanyu Shao
AU  - Youmin Wu
AU  - Cuiling Qin
AU  - Zhijiao He
AU  - Xinru Wang
AU  - Anqi Zhang
AU  - Nan Cao
AU  - Lan Hong
AU  - Yifeng Ling
AU  - Feng Wang
AU  - Qiang Dong
AU  - Xin Cheng
PY  - 2026
DA  - 2026/10/20
JO  - Journal of the American Heart Association
DO  - 10.1161/jaha.125.048868
UR  - https://www.ahajournals.org/doi/10.1161/JAHA.125.048868
AB  - Background Despite high recanalization rates with endovascular thrombectomy for large vessel occlusion stroke, a large proportion of patients remain disabled. This study aims to investigate the clinical impact of persistent hypoperfusion that was detected immediately after recanalization. Methods In this multicenter retrospective study of patients with large vessel occlusion with near‐complete or complete recanalization, perfusion maps were generated from post‐recanalization digital subtraction angiography. Focal hypoperfusion within the ischemic territory was detected and categorized as regional or cortical according to spatial distribution. The primary outcome was 90‐day functional independence (modified Rankin Scale 0 to 2). The associations of no‐reflow and outcomes were examined by multivariable logistic regression. Results Among 375 patients (median age 69 [interquartile range 57–77] years; 67.5% men), persistent hypoperfusion was detected in 29.6% of patients. Patients with hypoperfusion had higher baseline National Institutes of Health Stroke Scale (median 14 versus 12, P =0.076) and more thrombectomy passes ( P =0.021). The presence of persistent hypoperfusion was strongly associated with reduced functional independence (adjusted odds ratio [aOR]=0.23, 95% CI 0.13–0.39, P <0.001), higher rates of hemorrhagic transformation (aOR=1.88, 95% CI 1.14–3.11; P =0.013) and symptomatic intracranial hemorrhage (aOR=2.95, 95% CI 1.20–7.23; P =0.018). Quantitative analysis revealed minimum regional cerebral blood flow as a key factor of functional outcome (aOR=1.67, 95% CI 1.07–2.60; P =0.023). There is no significant agreement with 24‐hour computed tomography perfusion‐defined hypoperfusion (κ=0.106, P =0.524). Conclusions Persistent hypoperfusion could be detected immediately post‐recanalization in one‐third of successfully treated large vessel occlusion strokes. The adverse impact to functional outcome highlights its potential as an intraprocedural biomarker for future adjunctive therapies.
SN  - 2047-9980
ER  -