{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T05:39:00Z","timestamp":1792647540343,"version":"4.5.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this multicenter retrospective study of patients with large vessel occlusion with near\u2010complete or complete recanalization, perfusion maps were generated from post\u2010recanalization 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\u2010day functional independence (modified Rankin Scale 0 to 2). The associations of no\u2010reflow and outcomes were examined by multivariable logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 375 patients (median age 69 [interquartile range 57\u201377] 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,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.076) and more thrombectomy passes (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.021). The presence of persistent hypoperfusion was strongly associated with reduced functional independence (adjusted odds ratio [aOR]=0.23, 95% CI 0.13\u20130.39,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), higher rates of hemorrhagic transformation (aOR=1.88, 95% CI 1.14\u20133.11;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.013) and symptomatic intracranial hemorrhage (aOR=2.95, 95% CI 1.20\u20137.23;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.018). Quantitative analysis revealed minimum regional cerebral blood flow as a key factor of functional outcome (aOR=1.67, 95% CI 1.07\u20132.60;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.023). There is no significant agreement with 24\u2010hour computed tomography perfusion\u2010defined hypoperfusion (\u03ba=0.106,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.524).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Persistent hypoperfusion could be detected immediately post\u2010recanalization in one\u2010third of successfully treated large vessel occlusion strokes. The adverse impact to functional outcome highlights its potential as an intraprocedural biomarker for future adjunctive therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048868","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:52:27Z","timestamp":1791633147000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Hypoperfusion on Post\u2010Recanalization Digital Subtraction Angiography Perfusion Maps in Anterior Circulation Large Vessel Occlusion"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5041-6499","authenticated-orcid":false,"given":"Siyuan","family":"Li","sequence":"first","affiliation":[{"name":"National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University","place":["Shanghai, China"]},{"name":"Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2590-0764","authenticated-orcid":false,"given":"Wenhao","family":"Yang","sequence":"additional","affiliation":[{"name":"Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoshuai","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Hospital of Shanxi Medical University","place":["Taiyuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2996-5979","authenticated-orcid":false,"given":"Jiangshan","family":"Deng","sequence":"additional","affiliation":[{"name":"Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, 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