Recanalization and Reperfusion in Acute Stroke - More Often Different than Alike

Excerpt

In acute revascularization procedures in ischemic stroke, we currently make a distinction between recanalization and reperfusion. Recanalization literally means reopening of an occluded vessel. It is the direct goal of revascularization procedures and therefore a direct marker of technical success. Reperfusion means to restore blood flow in the formerly occluded vascular bed, especially in the nonvisible microcirculation. It is the prerequisite for stopping functionally inactive but viable brain tissue in the ischemic penumbra from becoming infarcted. Both processes have been regarded as a unit based on the assumption that recanalization will always lead to reperfusion. This led to a terminological confusion that is also reflected in current grading scales of endovascular treatment, which focus on reperfusion without recanalization or collateral circulation. The latter itself can alter flow in the distal vascular bed and therefore changes tissue outcome [1]. …