Abstract: Despite recent advances in endovascular treatment (EVT) techniques that have significantly increased the recanalization rate in patients with acute ischemic stroke (AIS), the incidence of futile recanalization (FR) remains high. Specifically, approximately half of AIS patients who undergo EVT and achieve successful complete reperfusion still have unfavorable functional outcomes at 90 days. It must be emphasized that recanalization itself is not the treatment endpoint; rather, substantial improvement in patients' functional prognosis is the ultimate goal of EVT. To this end, this article presents a systematic review of the factors influencing FR, aiming to thoroughly dissect and identify the key determinants of FR, thereby providing a theoretical basis for exploring effective intervention strategies and therapeutic targets.

Key words: Acute ischemic stroke, Endovascular therapy, Futile recanalization, Risk factors, Prognostic evaluation

摘要： 尽管近年来血管内治疗（EVT）技术的进步显著提高了急性缺血性脑卒中（AIS）患者的血管再通率，但无效再通（FR）的发生率仍然居高不下，具体而言，约半数接受 EVT 并成功实现完全再灌注的AIS患者，其 90 d功能预后依然不佳。需要强调的是，血管再通本身并非治疗终点，实现患者功能预后的实质性改善才是EVT的最终目标。为此，本文围绕FR的影响因素及风险评估进行系统综述，旨在深入剖析并明确导致FR的关键因素，以期为探索有效的干预策略及治疗靶点提供理论依据。

关键词: 急性缺血性脑卒中, 血管内治疗, 无效再通, 影响因素, 预后评估