Deans' stroke musings: Plasma metabolomic signatures of the no-reflow phenomenon in stroke patients following thrombectomy

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, June 29, 2026

Plasma metabolomic signatures of the no-reflow phenomenon in stroke patients following thrombectomy

Well shit, you're describing Capillaries that don't open due to pericytes;

known since September 2011. The whole stroke medical world IS COMPLETELY FUCKING INCOMPENT FOR NOT SOLVING THAT PROBLEM!

Plasma metabolomic signatures of the no-reflow phenomenon in stroke patients following thrombectomy

X
Xingtong Li 1†
X
Xi Chen 1†
H
Honghua Pan 2†
J
Junhua Wu 1
S
Shuai Mi 1
Y
Ying Jiang 1
Linke Zhou 1
Y
Yu Wang 1
M
X
Zhenhua Zhou 1*

1. Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
2. Guilin Municipal People's Hospital, Guangxi Zhuang Autonomous Region, Guilin, China

Abstract

Background:

Although successful recanalization of the occluded artery is achieved, no-reflow phenomenon (NRP) becomes a main contributor to poor prognosis in patients with acute ischemic stroke. There are some laboratory results to represent biomarkers of the no-reflow phenomenon. However, few studies have characterized the metabolomic signature of NRP. Using high-performance liquid chromatography–tandem mass spectrometry (LC–MS)-based method, this study aims to characterize the plasma metabolites associated with NRP.

Methods:

A total of 34 patients with acute large vessel occlusion in anterior circulation who underwent successful thrombectomy with final angiographic expanded Treatment in Cerebral Infarction score of 2c-3 score were enrolled (19 without NRP and 15 with NRP). Fasting venous blood collected 24 h after the procedure was centrifuged and subjected to metabolomic analysis.

Results:

We identified 29 differentially expressed plasma metabolites, the majority of which were phosphatidylcholine (PC) species. Among them, PC(20:4(5Z,8Z,11Z,14Z)/P-16:0) showed the most significant alteration and exhibited robust predictive performance (AUC = 0.846). The most prominently disrupted metabolic pathway was glycerophospholipid metabolism, particularly PC-mediated pathways, which appeared to play a central role in the association with of NRP.

Conclusion:

This study depict the plasma metabolic profile of NRP patients following stroke thrombectomy, and discover that phosphatidylcholine-dominated metabolites and related pathways may play a potential role in the occurrence of NRP. These metabolic biomarkers demonstrate promising discriminative ability and may help identify high-risk patients at an early stage, providing new targets for mechanism research and therapeutic intervention.