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Adnan Mujanovic, MD, Inselspital, Bern University Hospital, Switzerland, discusses perfusion abnormalities on 24-hour perfusion imaging among patients with complete macrovascular reperfusion. A recent meta-analysis on the no-reflow phenomenon, referring to microvascular reperfusion failure, found no-reflow to be associated with reduced rates of functional independence. However, results were inconsistent across centers. To look at this more deeply in his own center, Dr Mujanovic used perfusion imaging data from admission and follow-up, which identified four clusters of perfusion: normal, hyper-, hypo-, and mixed. The data indicated that microvascular hyperperfusion was related to a higher likelihood of better outcomes, whereas microvascular hypoperfusion was related to a lower likelihood of good outcomes. This research aligns with the no-reflow phenomenon and aims to better understand the role of microvascular patterns in stroke recovery. This interview took place at the 10th European Stroke Organisation Conference (ESOC) 2024 in Basel, Switzerland. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.