Search Results for: Short Acting Opioid

Stroke, Volume 56, Issue Suppl_1, Page ATP145-ATP145, February 1, 2025. Background:Located in Twin Cities, Minnesota (MN), HealthPartners Stroke INSPIRE (HPSI) is a free stroke survivor support program which offers support groups, education, peer mentoring, and leisure-based engagement opportunities for stroke survivors and caregivers. This 25-year-old program, which originated out of one hospital, is experiencing significant growth throughout the Midwest. Program growth is facilitated by the addition of virtual and in-person programs and has expanded to support a healthcare system of eight hospitals. HPSI provides support to stroke survivors and caregivers throughout the state of MN and internationally. HPSI program growth is supported by stroke system leadership and statewide partners. Expansion of HPSI has prompted data collection about participant demographics, experiences and priorities of stroke survivors and caregivers.Methods:Analysis of HPSI participant demographic, quality of life, attendance and support group topic trends were gathered from the HPSI Impact Pilot Quality Improvement Project (SIIP-QIP) and program tracking tools were reviewed. The SIIP-QIP collected qualitative information regarding stroke survivor demographic information, and perceptions of their Quality of Life, Affect and Well Being via the NEURO-Quality of Life Short Form.Results:HPSI has experienced a 36.3% increase in average group attendance sizes since October of 2022, with the average group sizes ranging from approximately 9-23 participants (Fig. 1). The most common support group topics are represented in Fig. 2 and 3. Demographic analysis indicates that 29.5% of participants had their most recent stroke in the last 1-5 years, while 38.7% experienced their most recent stroke over 6 years ago. Additionally, 45% of participants drive themselves, 63.2% reside in a major metropolitan area, 92.7% are non-Hispanic/Latino, 88.4% are white, 75% are 61 years old or older, 54.5% are male, and 45.5% are female. Perceptions of quality of life were generally consistent those who were not participating in HPSI.Discussion:As evidenced by consistent growth, high participant engagement, and demographic review, there is a need for expansion of community-based stroke specific support programming. Further study is needed to determine strategies for implementation of such programs in culturally diverse and rural communities. Research should explore the effects of stroke type and severity on support group participation and perceptions of quality of life.

Stroke, Volume 56, Issue Suppl_1, Page A60-A60, February 1, 2025. Introduction:Over 70% of patients experience post-stroke cognitive impairment (PSCI), which can lead to functional decline. Outpatient stroke clinics often lack a consistent and validated cognitive assessment protocol for follow-ups. This increases the risk of missed diagnosis of PSCI, which is often determined based on the subjective assessment of cognitive functioning by patients or caregivers. Our goal was to assess the practice of unstructured PSCI screening at our stroke clinic and test if a cognitive screening protocol would improve PSCI detection in follow-up patients.Methods:We led a quality improvement project to identify root causes of the problem and plan interventions for introducing a feasible cognitive screening protocol. We performed a baseline chart review on 79 stroke patients seen at the clinic to assess documentation of discussion of cognitive symptoms during visits. We developed a pre-screening survey to assess educational level, post-stroke rehabilitation participation, and vascular risk factors. We enrolled 30 follow-up patients with either an ischemic or hemorrhagic stroke. An examiner conducted a short-form MoCA (MoCA-sf) test and a CLCE-24 questionnaire for subjective cognitive complaints (SCC) on each patient. We collected data from the electronic record on discharge mRS and NIHSS scores and measured time spent on screening to assess feasibility.Results:In baseline chart review, 65% of 79 patients did not have any discussion of cognitive symptoms documented during their visit before our intervention. In our initial screening results, 53% of patients screened positive for cognitive impairment (

Stroke, Volume 56, Issue Suppl_1, Page ATP389-ATP389, February 1, 2025. Background:The variations in stroke volume are large and behavioral deficits are short-lived in rodent stroke models. These issues pose a challenge when using a rodent stroke model to test therapeutic interventions. The objective of this study is to explore composite analysis of multi-category behavioral outcomes for increasing the drug testing utility of the mouse middle cerebral artery occlusion (MCAO) model.Methods:Mice were subjected to 0 (sham), 20, 40, and 60 min MCAO, followed by 21 days of recovery. The rCBF was maintained at

Stroke, Volume 56, Issue Suppl_1, Page ATP386-ATP386, February 1, 2025. Background:Aging increases risk for the development of vascular cognitive impairment and dementia (VCID). Impaired bioenergetics, mitochondrial oxidative phosphorylation (OxPhos) and glycolysis, in the brain microvascular endothelium induce neurovascular uncoupling, which is one of the underlying mechanisms of VCID. Angiotensin (Ang)-(1-7) and Alamandine (Ala) are vascular protective peptides of renin angiotensin system. Ang-(1-7) is generated by angiotensin-converting enzyme-2 (ACE2) from Ang II, and produces vascular protective effects by acting on Mas receptor (MasR). Ala has been shown to be derived from Ang A by ACE2 or from Ang-(1-7) by an enzyme, which is yet to be characterized, with decarboxylase activity or Mas related G-protein-coupled receptor, member D (MrgD), respectively. This study evaluated the effect of aging on cellular bioenergetics in brain microvasculature (BMV) and tested the potential beneficial effects of Ang-(1-7) or Ala.Methods:BMVs were obtained from Young (Y) and Old (O) mice of age 3 – 4 and 22 – 24 months, respectively, by using ultracentrifugation method. Protein expression of receptors or mitochondrial complexes in BMVs were evaluated by western blotting. Seahorse bioanalyzer was used to determine OxPhos and glycolysis in BMVs.Results:Expression of MasR or MrgD was higher in the O-BMVs compared to the Young (P< 0.05, n = 4). Expression of mitochondrial respiratory complex proteins, II, IV and V, was lower in the O-BMVs (vs Y-BMVs,P< 0.05, n = 4). MitoStress test revealed that the basal and maximal respiration, and the spare capacity are lower in the O-BMVs compared to the Y-BMVs (P< 0.05). Ang-(1-7) or Ala (100 nM) increased the basal and maximal respiration, spare capacity and ATP production in the O-BMVs compared to the untreated (P< 0.05). Glycolysis rate assay (GRA) showed that basal glycolysis and basal proton efflux rate were lower in the O-BMVs (P< 0.01 vs Y-BMVs) that were increased by Ang-(1-7) or Ala.Conclusion:The study shows that aging is associated with impaired cellular bioenergetics in the brain microvasculature and that the angiotensin peptides, Ang-(1-7) or Ala, restore the bioenergetics therefore have the potential to reverse neurovascular uncoupling in aging.

Stroke, Volume 56, Issue Suppl_1, Page AWP26-AWP26, February 1, 2025. Introduction:Aneurysmal subarachnoid hemorrhage (aSAH) survivors suffer cognitive and behavioral challenges preventing their return to work and social activities. The factors that may affect neuropsychological outcomes after aSAH are not well characterized. This study aimed to analyze the clinical variables associated with the neuropsychological function in a large cohort of aSAH survivors.Methods:Patients with aSAH admitted to our institution since 2009 were recruited. Clinical variables, modified Rankin score (mRS) at discharge, hemorrhage volume, and the occurrence of vasospasm or new ischemia during hospitalization were collected. Patients underwent Montreal Cognitive Assessment (MoCA). Data was adjusted for sex, age, race, and years of education. Additionaly, patients completed the Beck Depression Inventory and the Stroke Specific Quality of Life questionnaires, while their families completed the Iowa Scale of Personality Changes. Univariate and multivariate analyses were performed to identify predictors of neuropsychological outcomes.Results:A total of 165 aSAH survivors were enrolled in the study. Short (32/165 patients) – and long-term outcomes (127/165 patients) were analyzed (3-12 months and 1 to 15 years post-aSAH respectively). In the short term, MoCA was significantly worse (

Stroke, Volume 56, Issue Suppl_1, Page ATP174-ATP174, February 1, 2025. Background and Purpose:Venous outflow (VO) impairment predicts unfavorable outcomes in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO). Prolonged venous transit (PVT), a visual qualitative VO marker on CT perfusion (CTP) time to maximum (Tmax) maps, has been associated with 90-day mortality despite successful reperfusion. This study investigates the association between PVT and modified Rankin Scale (mRS) score at discharge among AIS-LVO patients who have undergone successful reperfusion.Methods:We performed a retrospective analysis of prospectively collected data from consecutive adult AIS-LVO patients with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b/2c/3). PVT+ was defined as Tmax ≥10s in at least one of the following locations: superior sagittal sinus and/or torcula. The primary outcome was dichotomous mRS scores at discharge (favorable: mRS 0-2; unfavorable: mRS 3-6). Regression analyses were performed to assess the effect of PVT on discharge mRS.Results:In 119 patients of median (IQR) age 71 (63-81) years, a significantly higher proportion of PVT+ patients exhibited unfavorable mRS scores compared to PVT- patients (88.8% vs. 62.7%, p=0.004). After adjusting for age, sex, hypertension, hyperlipidemia, diabetes, atrial fibrillation, history of stroke or transient ischemic attack (TIA), tobacco use, administration of intravenous thrombolysis (IVT), admission National Institutes of Health Stroke Scale (NIHSS), Alberta Stroke Program Early CT (ASPECTS) score, and ischemic core volume, the PVT+ remains significantly associated with unfavorable mRS (OR=0.215, 95%CI 0.048-0.959, p=0.044).Conclusions:PVT+ was significantly associated with unfavorable mRS at discharge despite successful reperfusion in AIS-LVO patients, underscoring the importance of VO impairment in short-term functional outcomes. PVT serves as a valuable adjunct imaging biomarker derived from CTP for assessing VO profiles in AIS-LVO.

Stroke, Volume 56, Issue Suppl_1, Page AWP302-AWP302, February 1, 2025. Introduction:Colchicine, an anti-inflammatory medication, has demonstrated significant benefits in reducing inflammation and decreasing subsequent vascular events in patients with acute coronary syndrome and myocardial infarction (MI). This has prompted interest in its potential role in secondary prevention of vascular events in individuals who have experienced a stroke or transient ischemic attack (TIA). This abstract explores the evidence supporting colchicine’s efficacy and safety in this context.Methods:We searched PubMed, Cochrane, and Embase databases for randomized controlled trials investigating the effect of colchicine in patients who experienced stroke or TIA of non-cardioembolic origin. Our primary outcomes were any new vascular event (a composite of stroke, TIA, MI, or vascular death) or ischemic stroke. We also assessed the incidence of relevant side effects. Risk ratios (RR) and hazard ratios (HR) with 95% confidence intervals (CI) were pooled using a random-effects model.Results:Two studies were included with a total of 11,487 patients. Colchicine did not reduce vascular events after ischemic stroke or TIA both in long term (RR 0.91; 95% CI 0.79 to 1.05; p = 0.18; I2= 23%) (HR 0.92; 95% CI 0.80 to 1.04; p = 0.18; I2= 0%) and short term (RR 0.83; 95% CI 0.56 to 1.23; p = 0.35; I2= 64%) compared with placebo. There was also no significant advantage in the reduction of recurrence of ischemic stroke in the colchicine group (RR 0.90; 95% CI 0.74 to 1.09; p = 0.28; I2= 44%) (HR 0.91; 95% CI 0.75 to 1.10; p = 0.31; I2= 40%). There were no unforeseen side effects in the Colchicine group (RR 3.78; 95% CI 1.52 to 9.40; p= 0.001; I2= 91%).Conclusion:Colchicine did not prevent recurrent vascular events or ischemic strokes in patients after a non-cardioembolic stroke or TIA in a large sample size of greater than 11,000 patients. Further well-designed randomized controlled trials are needed to conclusively determine its efficacy and safety in this context. Nevertheless, the early data does not seem to indicate that it will provide benefit to this target population.

Stroke, Volume 56, Issue Suppl_1, Page AWMP11-AWMP11, February 1, 2025. Background:Endovascular thrombectomy (EVT) has improved both short-term and long-term outcomes for acute ischemic stroke (AIS) patients caused by large vessel occlusion (LVO). However, the relationships between blood pressure (BP) after EVT and outcomes had not been determined. As BP is dynamically changes, the present study investigated the effects of BP trajectories after EVT on the outcomes in AIS patients with LVO using Group-Based Trajectory Modeling (GBTM).Methods:This was a retrospective, single-center observational study. The AIS patients with LVO in the anterior circulation within 24 hours of symptom onset, baseline modified Rankin Scale (mRS) score ≤2, and Alberta Stroke Program Early CT Score (ASPECTS) score ≥6 were included. BP was monitored frequently post-EVT, and PP was calculated as the difference between systolic and diastolic BP. GBTM identified distinct PP trajectories over 0-6 hours and 0-48 hours post-EVT. Short-term outcomes included hemorrhagic transformation (HT) and symptomatic intracranial hemorrhage (SICH), while long-term outcomes included National Institutes of Health Stroke Scale (NIHSS) at 7 days and mRS score at 3 months.Results:Out of 506 screened patients, 313 were included in the final analysis. GBTM identified three distinct PP trajectories within the first 6 and 48 hours post-EVT. The 0–6 hour PP trajectory was significantly correlated with HT (OR=1.81, 95% CI 1.28-2.54), which remained significant after adjustment (OR = 1.72, 95% CI 1.17-2.53). An elevated PP trajectory was associated with a 3.04-fold higher risk of HT compared to the normal trajectory. Mediation analysis indicated the 7-day NIHSS score mediated 88.92% of the association between severe elevated PP trajectory and mRS.Conclusion:Severely elevated PP trajectory post-EVT is independently associated with poor short-term outcomes in AIS patients with LVO. Effective management of PP in the acute phase post-EVT may be crucial for improving prognosis of AIS patients with LVO.

Stroke, Volume 56, Issue Suppl_1, Page AWMP41-AWMP41, February 1, 2025. Introduction:Post-stroke cognitive decline (PSCD) is a common complication of strokes, and early assessment is crucial. However, outpatient cognitive assessment protocols are inconsistent, leading to missed diagnoses of PSCD. A potential solution is the XpressO application, introduced in 2023 by the creators of the Montreal Cognitive Assessment (MoCA). Because XpressO is self-paced, it can be completed by patients while waiting for an appointment and hence can assess cognition without impacting clinic workflow.Hypothesis:This study aims to investigate the feasibility of using the XpressO online self-administered cognitive assessment and compare its ability to detect PSCD with the MoCA short form (MoCA-sf) at our out-patient stroke clinic.Methods:Patients at the clinic with a history of ischemic or hemorrhagic strokes were included. We used

Stroke, Volume 56, Issue Suppl_1, Page AWP315-AWP315, February 1, 2025. Objective:We sought to investigate the consequences of alcohol intake on intracerebral hemorrhage (ICH) and cerebral small vessel disease (cSVD) in patients with spontaneous ICH.Methods:We compared markers of cSVD [Figure 1], features of ICH, and outcomes among consecutive spontaneous ICH patients with different alcohol use strata admitted to a tertiary care center between 2003-2019. Alcohol intake was categorized as none/mild (5 drinks/day). We performed descriptive statistics and bivariate/multivariate analyses based on demographic and radiologic data.Results:We included 1590 patients (53% male, median age 74 years [IQR 64-82]). Among them, 82.6% had none/mild alcohol intake, 14.2% moderate/severe, and 3.3% heavy alcohol intake. Heavy alcohol users were 13 years younger at time of ICH than none/mild users (median [IQR], 62 [57-70] vs 75 [65-83], p

Stroke, Volume 56, Issue Suppl_1, Page AWP42-AWP42, February 1, 2025. Background and Objectives:Moyamoya disease (MMD) is characterized by progressive steno-occlusion of the internal carotid arteries, leading to compensatory collateral vessel formation. The optimal surgical approach for MMD remains debated, with bilateral revascularization potentially offering more comprehensive protection but involving more extensive surgery compared to unilateral revascularization. This study aims to compare bilateral revascularization and unilateral revascularization short-term safety profile in the treatment of MMD.Methods:This multicenter retrospective study included patients with MMD who underwent surgical revascularization at 13 academic institutions. Patients were categorized into unilateral and bilateral revascularization groups. Data collected included demographics, clinical characteristics, and outcomes. Propensity score matching (PSM) was used to balance baseline characteristics. Statistical analyses were conducted using Stata (V.17.0; StataCorp).Results:A total of 497 patients were included, including 90 that had bilateral revascularization and 407 that had unilateral revascularization. Bilateral revascularization was associated with more perioperative asymptomatic strokes (10% vs. 2.4%; OR 4.41, 95% CI 1.73 to 11.19, p = 0.002) and higher rates of excellent functional outcomes (mRS 0-1) at discharge (92.2% vs. 79.1%; OR 3.12, 95% CI 1.39 to 7, p = 0.006). After PSM, 57 matched pairs were analyzed. There was a higher rate, though not statistically significant difference, of perioperative stroke in the bilateral revascularization group (15.7% vs. 8.7%; OR 1.95, 95% CI 0.61 to 6.22, p = 0.26). No significant differences were noted in mRS 0-1 and 0-2 scores at discharge, NIHSS at discharge, intraoperative complications, or length of hospital stay. The follow-up stroke rates were also not significantly different (OR 0.40, 95% CI 0.11 to 1.39, p = 0.15).Conclusion:This study found no significant differences between bilateral and unilateral revascularization in MMD. Patients who had bilateral revascularization had higher tendency of perioperative stroke, though not statistically significant. Further prospective studies are needed to validate these results.

Stroke, Volume 56, Issue Suppl_1, Page AWMP45-AWMP45, February 1, 2025. Introduction:There has been an ongoing debate regarding the effectiveness of inpatient rehabilitation facility (IRF) and skilled nursing facility (SNF) in promoting functional recovery. Home time is a valid measure of functional recovery in stroke patients that is often used in outcome studies. Considering that SNF patients have twice the length of stay compared to IRF patients, our objective was to explore whether home time is a suitable measure to compare the effectiveness between IRF and SNF in achieving functional recovery.Methods:We probabilistically linked data from Michigan’s Coverdell Stroke Program and Michigan Value Collaborative multipayer claims database for Medicare FFS beneficiaries hospitalized with acute stroke (ICD-10 I61-I63) between 2016-2020. Patients admitted to IRF or SNF after hospital discharge were confirmed using claims data. Home time was calculated over 90-days and 1-year following hospital discharge by subtracting the number of days spent in inpatient setting (i.e., IRF, SNF, and long-term care) from the number of days alive. We calculated the crude and inverse probability of treatment weighted (IPTW) mean difference of home time between IRF and SNF groups. We conducted a sensitivity analysis to examine the effect of time spent in the same rehabilitation setting over 30-days post discharge on home time.Results:From a cohort of 14,316 linked patients, we identified 2,995 (20.9%) and 2,948 (20.6%) patients directly admitted to IRF or SNF following stroke hospitalization, respectively. Compared to SNF patients, IRF patients were younger, more likely to be male, had minor strokes (NIHSS 1-4), and were able to ambulate at discharge. The unadjusted 90-day and 1-year mean home time were 15.6 and 67.6 days higher among IRF patients compared to SNF patients, respectively (Table). After accounting for rehabilitation time during 30-days post discharge, 90-day and 1-year unadjusted mean difference in home time remained higher among IRF patients compared to SNF patients but was reduced to 4.6 and 56.5 days, respectively. Using the amended home time, the adjusted 90-days mean difference was almost zero and not significantly different (0.5 days) but remained significantly different over 1-year (35.7 days).Conclusions:Home time is heavily impacted by rehabilitation length of stay. Future rehabilitation related studies should be cautious when using home time as a measure of functional recovery, especially over short duration of follow-up.

Stroke, Volume 56, Issue Suppl_1, Page AWP353-AWP353, February 1, 2025. Mesenchymal stem cells (MSCs) have recently received attention as an intervention to reverse or slow neurodegenerative, stroke and injury-related changes in the aging brain as they suppress inflammation and facilitate tissue repair. In support of this idea, we have shown that extracellular vesicles (EVs) derived from bone marrow MSCs enhance recovery of motor function of the hand following cortical injury in aged female rhesus monkeys. Specifically, EV-treated treated monkeys (n=5) exhibited full recovery of fine motor function by 3-5 weeks post-injury while vehicle monkeys (n=5) reached a plateau short of full recovery by 8-12 weeks post-injury. Post-mortem analyses of perilesional brain tissue from the same monkeys, revealed multifaceted cellular effects of EVs including downregulating inflammatory microglial phenotypes, dampening neuronal hyperexcitability, and enhancing neuronal and myelin plasticity. To explore the relationship between these processes and functional recovery, we utilized multi-labeling immunohistochemistry (IHC) and high-resolution confocal microscopy to assess microglia phenotypes, neuronal synaptic marker expression and microglia-neuronal interactions in perilesional cortex. To assess these markers, semi-quantitative stereology in Neurolucida and particle analysis in ImageJ were utilized. Results show that MSC-EV treatment decreased the densities of pro-inflammatory hypertrophic microglia expressing LN3+, a marker for MHC II receptors, upregulated with immune activation. Conversely, MSC-EV treatment and functional recovery was significantly correlated with increased proportion of hypertrophic microglia expressing the key complement pathway protein C1q, a phenotype associated with enhanced debris-clearance and repair after degeneration. Interestingly this EV-associated increase in C1q+ hypertrophic microglia was correlated with decreased putatively damaged synapses tagged with C1q and greater synaptic marker expression in perilesional cortex. These data suggest that MSC-EVs promote a shift from pro- to anti-inflammatory repair microenvironment, via enhancement of debris clearance after injury. These findings demonstrate the efficacy of MSC-EVs as a therapeutic, likely acting to reduce inflammatory cascades, facilitate repair and rebalance neuronal synaptic connections to support recovery after cortical injury.

Stroke, Volume 56, Issue Suppl_1, Page AWMP56-AWMP56, February 1, 2025. Background:Nearly one million individuals in the U.S. experience ischemic stroke annually and one-year recurrent stroke risk may exceed 10%. The American Heart Association (AHA) Get-With-The-Guidelines-Stroke® Registry (GWTG-S) suggests that more than 40% of patients with stroke are discharged with a cryptogenic or undocumented etiology which may lead to suboptimal secondary prevention. Consequently, improved neurology and cardiology collaboration and evidence-based post-stroke evaluation may help identify stroke etiology, reduce recurrences and improve outcomes.Methods:In 2022, the AHA, in collaboration with HCA Healthcare and HCA Healthcare Foundation, designed and launched Getting to the Heart Of StrokeTMin 10 HCA Healthcare advanced stroke centers (GTTHOS) to improve neurology and cardiology collaboration, evidence-based post-stroke diagnostic evaluation and assessment of social determinants of health and barriers to care. Components included a learning collaborative model, virtual performance improvement consultations, Plan-Do-Study-Acts, multidisciplinary teams and performance improvement feedback. This analysis compared GTTHOS centers to the rest of HCA Healthcare’s GWTG-S centers (Non-GTTHOS; n=112) at baseline (2022) and follow-up (2023), using custom and existing GWTG-S metrics.Results:At follow-up, GTTHOS documented higher stroke etiology rates (58.06% vs. 48.63%), lower cryptogenic stroke (31.01% vs. 34.89%) and lower undocumented stroke etiology (10.93% vs. 16.48%)(all vs. baseline; p

Stroke, Volume 56, Issue Suppl_1, Page AWP368-AWP368, February 1, 2025. Introduction:Oxidative stress plays an important role in both early brain injury and delayed cerebral ischemia after subarachnoid hemorrhage (SAH). Despite the beneficial effects demonstrated in preclinical studies with drugs targeting oxidative stress, their clinical translation has been hindered. There were critical issues in previous preclinical studies underpinning clinical translation, including inadequate demonstration of blood-brain barrier (BBB) penetration and insufficient assessment of drug concentration and biological activity in brain tissue. MnP-05 is a novel manganese porphyrin-based superoxide-dismutase mimic, which penetrates the BBB far better than previous compounds and exhibits superior anti-free radical properties compared to previous free radical scavenger. In this study, we evaluated the effect of MnP-05 on short-term outcomes of SAH in mice.Methods:We used 12-week-old male C57BL/6J mice. We induced SAH by an endovascular perforation of the right internal carotid artery. Mice (n = 31) were started on treatment with either MnP-05 or PBS 60 minutes after the induction of SAH. We set the dosing regimen as 1 mg/kg intravenous bolus followed by 5 mg/kg/day continuous intraperitoneal injection for 72 hours. We compared a composite neurological score, and rotarod performance (%baseline), between the two treatment groups for 7 days. We also compared the mRNA expression of oxidative stress and apoptosis markers in perihematomal brain tissue between the groups.Results:There were no specific side effects found in MnP-05 treatment group. There were no differences in blood pressure or body weight between the two groups. Seven-day neurological outcomes were better in MnP-05 group as evidenced by the significantly better composite neurological scores (22.9 vs. 19.4, P

Stroke, Volume 56, Issue Suppl_1, Page AWP357-AWP357, February 1, 2025. Introduction:The rapid recanalization of occluded vessels and the restoration of cerebral blood flow (CBF) are critical for the outcome of stroke. Patients may exhibit poor reperfusion (no-flow) or hyperperfusion (hyperemia) after recanalization, and factors influencing these conditions are not fully understood. The Stroke Preclinical Assessment Network (SPAN) conducted a randomized, controlled, blinded, and highly heterogeneous multi-laboratory trial to identify effective interventions in the stroke animal model. Here, we examined the factors influencing the CBF recovery after filament removal and the effect of reperfusion CBF on stroke outcome in SPAN.Methods:Both sexes of C57BL6 healthy young were subjected to 30 or 60-minutes transient endovascular filament middle cerebral artery occlusion (MCAO). For homogeneity of all other factors, we used subjects enrolled at Mass General Hospital only. We measured CBF at 5 (n=128) and 10 minutes (n=88) after filament removal by laser Doppler flowmetry. We first tested whether sex, surgeons, MCAO duration, circadian time (ZT) at MCAO, age, weight, surgical duration, and SPAN treatments (control, fasudil, fingolimod, tocilizumab, uric acid, veliparib) predicted the reperfusion CBF. We then assessed the influence of CBF on tissue (day-2 MRI lesion volume) and behavioral outcomes (acute neurological deficits score and day-7 and 28 corner test) and 30-day mortality. A generalized linear model with backward elimination and a mixed model were used for bivariate and multivariable analyses.Results:CBF gradually increased after filament removal between 5 and 10 minutes (p=0.03). In bivariate analyses, CBF was significantly lower in animal that had MCAO in their active circadian phase (ZT12-24) (p=0.04). In multivariable analysis, reperfusion CBF was predicted to be higher in females, after 60 min MCAO, in inactive phase (ZT0-12), and short anesthesia duration. CBF also differed among the three surgeons. Only tocilizumab had lower CBF compared to the control group. Reperfusion CBF did not predict tissue and behavioral outcomes. However, higher CBF was related to lower day-1 weight loss (p