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The overall very poor prognosis has recently led investigators to evaluate, in randomized clinical trials, the potential benefit of endovascular recanalization in patients with acute ischemic stroke due to a large vessel occlusion in the distal internal carotid artery and MCA M1 segment who have already a large core of infarction [Alberta Stroke Program Early CT Score (ASPECTS) 36 h) are believed to be related to the activation of brain-derived proteases such as MMP-9, neuroinflammation, and factors that promote vascular remodeling such as vascular endothelial growth factor (VEGF) (66)

While it effectively bypasses digestion, it introduces higher costs and safety risks compared to oral or topical alternatives

This geographic concentration represents an important methodological limitation that researchers must be aware of when critically analyzing results