What factors predispose patients who undergo thrombectomy to repeatedly embolize to the same artery despite successful recanalization, other than ICAD?

Intracranial atherosclerotic disease is a well-recognized cause of recurrent ischemic stroke through repeated in situ thrombosis and distal artery-to-artery embolization, predisposing patients to recurrent infarction within the same vascular territory. Likewise, high-risk extracranial atherosclerotic plaques, particularly those involving the ipsilateral proximal internal carotid artery, may serve as a persistent embolic source, resulting in repeated embolization to the same intracranial artery, most commonly the middle cerebral artery (MCA). Although less common, severe hypercoagulable states - including malignancy-associated hypercoagulability, nonbacterial thrombotic endocarditis (NBTE), and antiphospholipid syndrome (APS) - can also lead...