Although chronic middle cerebral artery occlusion (CMCAO) is less critical than acute middle cerebral artery (MCA) occlusion, it is associated with a significant risk of mortality and disability. Patients with CMCAO may experience progressive cerebral hypoperfusion due to reduced cerebral blood flow (CBF), which can result in recurrent transient ischemic attacks (TIAs), ischemic strokes, and, in severe cases, death. The recurrence risk of stroke in CMCAO ranges from 3.6 % to 22.0 % [1–3], and af…