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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)

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