{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:47:32Z","timestamp":1791229652708,"version":"4.1.0"},"reference-count":51,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite successful recanalization after endovascular thrombectomy, more than half of patients with acute ischemic stroke with large\u2010vessel occlusions experience an unsatisfactory outcome. Incomplete microvascular reperfusion may contribute to it, but its occurrence remains debated, partly due to clinical observations of hyperperfusion after recanalization. This study investigates the relationship between ischemia duration, infarct development, microclot presence, and cerebral perfusion in a swine model of focal cerebral ischemia and reperfusion.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Twenty\u2010three swine underwent craniectomy and were randomized into 5 groups: 1\u2010hour, 2\u2010hour, or 4\u2010hour occlusion followed by 4\u2010hour recanalization, 8\u2010hour occlusion without recanalization (positive control), or without occlusion (sham). Middle cerebral artery occlusion was induced using aneurysm clips, with 3\u2010dimensional digital subtraction angiography confirming occlusion and recanalization. Three\u2010dimensional digital subtraction angiography was used for quantification of area at risk and tissue perfusion. Infarct size was measured using 2,3,5\u2010triphenyl\u20102H\u2010tetrazolium chloride staining. The presence of microclots was quantified using CD61+ platelet immunostaining (number\/mm\n              <jats:sup>2<\/jats:sup>\n              ). Plasma markers of coagulation activation were measured before and during middle cerebral artery occlusion and after recanalization.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Area at risk\u2013normalized infarct size increased significantly with ischemia duration (\n              <jats:italic toggle=\"no\">r<\/jats:italic>\n              =0.8,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001). Compared with the noninfarcted hemisphere, microclots in the infarcted hemisphere increased in middle cerebral artery occlusion groups (0.07 [0.04\u20130.13] versus 0.33 [0.16\u20130.71],\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.003). Microclot density in area at risk region showed a positive correlation with ischemia duration (\n              <jats:italic toggle=\"no\">r<\/jats:italic>\n              =0.7,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              =0.007), while no such correlation was observed in remote region. Simultaneously, higher perfusion levels were observed at both 2\u2009hours (1.27\u00b10.19,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001) and 4 hours (1.23\u00b10.16,\n              <jats:italic toggle=\"no\">P<\/jats:italic>\n              &lt;0.001) following recanalization, irrespective of the duration of ischemia. No activation of coagulation was detected in systemic plasma.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Focal cerebral ischemia and reperfusion result in a substantial presence of microclots, which occurs alongside hyperperfusion in this swine model of recanalized acute ischemic stroke. These platelet microclots extend beyond the ischemic area. The density of microclots within the ischemic region increased with prolonged ischemia.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.125.042663","type":"journal-article","created":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T04:38:31Z","timestamp":1757133511000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Microvascular Occlusion and Postrecanalization Hyperperfusion in a Swine Model of Acute Ischemic Stroke"],"prefix":"10.1161","volume":"14","author":[{"given":"Meiqi","family":"Wang","sequence":"first","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1300-7477","authenticated-orcid":false,"given":"Aladdin","family":"Taha","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]},{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8575-5936","authenticated-orcid":false,"given":"Magdolna","family":"Nagy","sequence":"additional","affiliation":[{"name":"MUMC and CARIM School for Cardiovascular Diseases","place":["Maastricht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jadey D.","family":"Raben","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romy","family":"van Noort","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-5360","authenticated-orcid":false,"given":"Victor","family":"Volovici","sequence":"additional","affiliation":[{"name":"Erasmus MC Stroke Center, Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]},{"name":"Erasmus MC University Medical Centre","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-0644","authenticated-orcid":false,"given":"Ruben","family":"Dammers","sequence":"additional","affiliation":[{"name":"Erasmus MC Stroke Center, Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]},{"name":"Erasmus MC University Medical Centre","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-2241","authenticated-orcid":false,"given":"Dirk J.","family":"Duncker","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3858-334X","authenticated-orcid":false,"given":"Henri","family":"Spronk","sequence":"additional","affiliation":[{"name":"MUMC and CARIM School for Cardiovascular Diseases","place":["Maastricht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7796-4463","authenticated-orcid":false,"given":"Hugo","family":"ten Cate","sequence":"additional","affiliation":[{"name":"MUMC and CARIM School for Cardiovascular Diseases","place":["Maastricht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9234-3515","authenticated-orcid":false,"given":"Diederik","family":"Dippel","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9026-5226","authenticated-orcid":false,"given":"Joaquim","family":"Bobi","sequence":"additional","affiliation":[{"name":"Erasmus MC University Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2930-1152","authenticated-orcid":false,"given":"Heleen M. 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