WHOM is going to solve this problem? I'd say the problem is specifically this:
Capillaries that don't open due to pericytes September 2011
And you incompetently did not know that along with your mentors and senior researchers? What the fuck are you doing in stroke if you know nothing? Everyone involved in this needs to be fired!
No-reflow phenomenon in stroke patients: A systematic literature review and meta-analysis of clinical data
Abstract
Background:
The no-reflow phenomenon refers to the absence of microvascular reperfusion despite macrovascular reperfusion.
Aim:
The aim of this analysis was to summarize the available clinical evidence on no-reflow in patients with acute ischemic stroke.
Methods:
A
systematic literature review and a meta-analysis of clinical data on
definition, rates, and impact of the no-reflow phenomenon after
reperfusion therapy was carried out. A predefined research strategy was
formulated according to the Population, Intervention, Comparison, and
Outcome (PICO) model and was used to screen for articles in PubMed,
MEDLINE, and Embase up to 8 September 2022. Whenever possible,
quantitative data were summarized using a random-effects model.
Results:
Thirteen
studies with a total of 719 patients were included in the final
analysis. Most studies (n = 10/13) used variations of the Thrombolysis
in Cerebral Infarction scale to evaluate macrovascular reperfusion,
whereas microvascular reperfusion and no-reflow were mostly assessed on
perfusion maps (n = 9/13). In one-third of stroke patients with
successful macrovascular reperfusion (29%, 95% confidence interval (CI),
21–37%), the no-reflow phenomenon was observed. Pooled analysis showed
that no-reflow was consistently associated with reduced rates of
functional independence (odds ratio (OR), 0.21, 95% CI, 0.15–0.31).
Conclusion:
The
definition of no-reflow varied substantially across studies, but it
appears to be a common phenomenon. Some of the no-reflow cases may
simply represent remaining vessel occlusions, and it remains unclear
whether no-reflow is an epiphenomenon of the infarcted parenchyma or
causes infarction. Future studies should focus on standardizing the
definition of no-reflow with more consistent definitions of successful
macrovascular reperfusion and experimental set-ups that could detect the
causality of the observed findings.
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