Highlight
– Elevated peri-infarct relative heterogeneity of capillary transit time (RTH) detected by perfusion MRI immediately after thrombectomy predicts subsequent infarct growth and poor functional outcomes in acute ischemic stroke despite excellent macrovascular reperfusion.
– Microvascular hemodynamic impairment, specifically increased capillary transit time heterogeneity, serves as an imaging biomarker of the no-reflow phenomenon.
– This study identifies peri-infarct microvascular dysfunction as an independent predictor of clinical deterioration and highlights its potential role in guiding post-reperfusion interventions.
