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Intravenous thrombolysis and mechanical thrombectomy for acute ischemic stroke are largely focused on recanalization, but enhancing collateral blood flow could also improve perfusion and limit infarction. Stimulation of the sphenopalatine ganglion, which is accessible through the nasal mucosa, is thought to increase collateral cerebral blood flow through parasympathetic effects on anterior circulation vasculature and has been proposed as a potential intervention for stroke.
In an industry-sponsored trial, investigators randomized 1078 patients with anterior circulation, nonlacunar stroke and National Institutes of Health Stroke Scale (NIHSS) scores between 7 and 18, to sphenopalatine ganglion stimulation or corresponding sham procedures, ini…