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Related Concept Videos

First Pass Effect01:12

First Pass Effect

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Presystemic elimination, or the first-pass effect, is the metabolism of drugs that reduces their effective concentration at the site of action. Apart from the first-pass effect, the systemic bioavailability of the drug is also reduced by other factors, including incomplete absorption or chemical degradation of drugs.
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Integral membrane proteins are tightly associated with the cell membrane and play a crucial role in cell communication, signaling, adhesion, and transport of the molecules. Some integral membrane proteins are present only in the membrane monolayer. For example, the enzyme fatty acid amide hydrolase is present in the cytoplasmic side of the membrane monolayer. In contrast, another type of integral membrane protein, also known as a transmembrane protein, spans across the membrane. Transmembrane...
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When a drug is taken orally, it undergoes a journey starting from the gastrointestinal (GI) tract, passing through the portal vein, reaching the liver, and finally entering the systemic circulation. This process involves the absorption of the drug across the GI tract. The liver is the primary site for metabolizing the drug, with some metabolism also occurring in the gut wall. This journey significantly reduces the quantity of the drug that reaches the systemic circulation, a phenomenon known as...
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Integral membrane proteins are proteins adhered to the lipid bilayer of a cell organelle or membrane. They can be of two types: transmembrane integral proteins that span the lipid bilayer and monotopic proteins that are attached to either side of the membrane but do not pass through it.
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The rough ER membrane synthesizes, assembles, and embeds transmembrane proteins in diverse topologies. These proteins function as transporters or channels and can remain in the ER membrane or are sent to the Golgi complex, lysosome, and cell membrane.
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Multi-pass Transmembrane Proteins and β-barrels01:09

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In multi-pass transmembrane proteins, the polypeptide chain crosses the membrane more than once. The transmembrane polypeptide chain either forms an α-helix or β-strand structure. α-Helix containing multi-pass transmembrane proteins are ubiquitous, whereas β-strand containing ones are mainly found in gram-negative bacteria, mitochondria, and chloroplasts.
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Complete Sudden Recanalization: There Is Hope Beyond the First Pass Effect.

Manuel Requena1,2,3, Álvaro García-Tornel1,3, Isabel Rodríguez4

  • 1Unitat d'Ictus Hospital Universitari Vall d'Hebron Barcelona Spain.

Stroke (Hoboken, N.J.)
|January 26, 2026
PubMed
Summary

Complete sudden recanalization (cSR) in stroke patients undergoing endovascular treatment is linked to better outcomes. This pattern, achieved in one pass, independently predicts favorable functional outcomes, regardless of the total number of passes.

Keywords:
endovascular treatmentmechanical thrombectomystroke

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Area of Science:

  • Neurology
  • Interventional Radiology
  • Cardiovascular Diseases

Background:

  • Endovascular treatment aims for rapid, complete recanalization in stroke patients.
  • The pattern of recanalization per pass is crucial for procedural success.

Purpose of the Study:

  • To investigate the impact of per-pass recanalization patterns on outcomes in patients with final complete recanalization.
  • To determine if complete sudden recanalization (cSR) is associated with improved functional outcomes.

Main Methods:

  • Retrospective analysis of 400 patients with internal carotid artery or M1-middle cerebral artery occlusion treated endovascularly.
  • Defined complete sudden recanalization (cSR) as achieving expanded thrombolysis in cerebral infarction (eTICI) 2c-3 in a single pass.
  • Compared outcomes between cSR and complete progressive recanalization groups.

Main Results:

  • 75% of patients (301/400) achieved cSR.
  • The cSR group had fewer passes (1 vs. 2) and shorter times to recanalization (27 vs. 46 minutes).
  • cSR was an independent predictor of good functional outcome at 90 days (57.8% vs. 44.4%, aOR 1.72).

Conclusions:

  • Complete sudden recanalization (cSR) is a significant predictor of favorable outcomes in stroke patients with large vessel occlusion.
  • The positive impact of cSR on outcomes is independent of the total number of thrombectomy passes required.