Remote Ischemic Conditioning for Acute Ischemic Stroke Treated With Mechanical Thrombectomy（RECAST-MT）

Prior treatment

• Clinical history, previous imaging examinations, or clinical judgment suggesting intracranial tumors, arteriovenous malformations, or intracranial arterial dissection;

Other illness

• Difficult-to-control hypertension: continuous monitoring upon admission shows systolic blood pressure ≥180mmHg, or diastolic blood pressure ≥100mmHg;
• Pre-stroke modified Rankin Scale (mRS) score \>1;
• Cranial CT or MRI shows intracranial hemorrhage;
• History of head injury in the past 3 months;
• History of life-threatening allergy to contrast agents, nickel, titanium metal, or their alloys;
• Limb deformity, soft tissue injury, or other conditions that affect the implementation of distant ischemia adaptation therapy;
• Other conditions that the investigators believe are not suitable for participation in this study.

Lab values

• Presence of bleeding tendency, deficiency of coagulation factors, or oral anticoagulant therapy with INR \> 3.0;
• Baseline blood glucose \<2.7mmol/L or \>22.2mmol/L;
• Baseline platelet count \< 30\*10\^9/L;
• Severe known renal impairment defined as requiring dialysis (hemodialysis or peritoneal dialysis), or if known creatinine clearance rate \<30mL/min;
• Pregnancy, if women of childbearing age have a positive urinary or serum β-human chorionic gonadotropin (β-hCG) test or are breastfeeding；

Other

• Imaging examination revealed the presence of multiple vascular supply areas of cerebral infarction (such as the simultaneous presence of infarction in both anterior and posterior circulation);
• Absence of femoral artery pulsation, extremely difficult intravascular access, or extremely tortuous large vessels, which are expected to result in the inability to undergo timely endovascular treatment;
• Coma or lethargy patients (consciousness level score ≥2 in NIHSS);
• Unable to obtain an accurate baseline NIHSS score;
• Baseline ASPECTS score ≤5;
• Cranial CT or MRI shows midline deviation and significant occupying effect;
• The life expectancy of patients is less than 6 months, and they cannot be evaluated within 3 months;
• Participating in other ongoing clinical trials;

• Age≥18 years；
• Acute ischemic stroke due to large vessel occlusion in the anterior circulation that is not suitable for intravenous thrombolytic therapy, or has contraindications to intravenous thrombolytic therapy, or treated with intravenous thrombolytic therapy without recanalization;
• Large vessel occlusion confirmed by computed tomography angiography (CTA) or magnetic resonance angiography (MRA), including the occlusion of the intracranial segment of the internal carotid artery (ICA) and M1 segment of the middle cerebral artery (MCA), is the cause of symptoms, and mechanical thrombectomy is planned within 24 hours from the time last known well;
• Baseline score of the National Institutes of Health Stroke Scale (NIHSS) ≥ 6 points;
• Patients or family members signed a written informed consent form.