Related Experiment Video
Updated: Aug 13, 2026

A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
Published on: June 4, 2021
EXPRESS: Immunothrombosis May Drive Futile Reperfusion in Stroke
1Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213, USA.
None:
Mechanical thrombectomy has made angiographic reperfusion routine for large-vessel occlusion stroke, yet functional recovery remains inconsistent. Growing evidence links this therapeutic ceiling to the no-reflow phenomenon, defined as persistent tissue-level hypoperfusion despite proximal patency. No-reflow may arise from ischemia-reperfusion microvascular injury and distal microembolization, creating conditions that may promote immunothrombotic obstruction. Neutrophil-platelet cooperation, endothelial activation, and neutrophil extracellular traps represent candidate mechanisms linking capillary failure to futile reperfusion. Future trials should prospectively phenotype no-reflow with early perfusion imaging, integrate mechanistic biomarkers, and test microvascular-facing adjuncts that convert macrovascular recanalization into durable tissue reperfusion.
Related Concept Videos
Venous Thrombosis III: Interprofessional Care
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Venous Thrombosis I: Introduction
Transient Ischemic Attack l: Introduction
Ischemic Stroke ll: Pathophysiology
