No-Reflow Phenomenon after Mechanical Thrombectomy for Acute Ischemic Stroke with Large Vessel Occlusion: Imaging Assessment and Treatment Progress

doi:10.3969/j.issn.1673-5765.2025.12.016

Abstract

Abstract: Mechanical thrombectomy is the standard treatment for acute ischemic stroke with large vessel occlusion (AIS-LVO) within 24 hours of onset. However, some patients who achieve successful vascular recanalization after mechanical thrombectomy still suffer from insufficient microcirculatory perfusion in the ischemic area, a condition known as no-reflow phenomenon (NRP). NRP following mechanical thrombectomy can significantly compromise the prognosis of AIS-LVO patients. As current angiography cannot effectively identify no-reflow areas, accurate assessment, prevention, and treatment of NRP remain challenges. This article systematically reviews the imaging assessment methods, prevention and treatment strategies of NRP after mechanical thrombectomy in AIS-LVO patients based on recent domestic and international literature, with the aim of providing a reference for clinical decision-making.

Key words: Stroke; Large vessel occlusion; Mechanical thrombectomy; No-reflow phenomenon

摘要： 机械取栓是急性大血管闭塞性缺血性卒中（acute ischemic stroke with large vessel occlusion，AIS-LVO）患者发病24 h内的标准治疗方案。然而，部分机械取栓后获得成功血管再通的患者仍存在缺血区域微循环灌注不足，即无复流现象（no-reflow phenomenon，NRP）。机械取栓后NRP可显著影响AIS-LVO患者的预后。目前，常规血管造影技术难以有效识别无复流区域，使得NRP的准确评估、预防及治疗仍面临挑战。本文结合国内外研究进展，系统综述AIS-LVO患者机械取栓后NRP的影像评估方式、预防与治疗策略，以期为临床诊疗实践提供参考。

关键词: 卒中; 大血管闭塞; 机械取栓; 无复流现象

CLC Number:

YANG Keke, LI Chenwei, WANG Xiaojun, RAN Jianglin, FENG Zhiheng, PENG Huiyuan. No-Reflow Phenomenon after Mechanical Thrombectomy for Acute Ischemic Stroke with Large Vessel Occlusion: Imaging Assessment and Treatment Progress[J]. Chinese Journal of Stroke, 2025, 20(12): 1590-1597.

杨珂珂, 李晨威, 王小军, 冉江林, 冯志恒, 彭慧渊. 急性大血管闭塞性缺血性卒中机械取栓后无复流现象：影像评估与治疗进展[J]. 中国卒中杂志, 2025, 20(12): 1590-1597.

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