HBO After Thrombectomy for AIS With LVO

Prior treatment

• Females of pregnancy, or positive pregnancy test prior to randomization;
• Participating in other drug or medical device clinical trials;

Other illness

• Patients with extensive bleeding or severe increase in infarct area, midline displacement (\>0.5cm), etc. during endovascular treatment, who plan to undergo bone valve decompression or ventricular drainage;
• Severe persistent and medication-uncontrollable hypertension (systolic blood \> 185 mmHg or diastolic blood \> 110 mmHg)
• End-stage disease other than the nervous system, life expectancy \< 90 days;
• Patients with anemia, polycythemia or other conditions requiring urgent oxygen;
• Unable to cooperate with hyperbaric oxygen therapy, or have other diseases that are not suitable for hyperbaric oxygen therapy (such as active/chronic obstructive pulmonary disease, acute respiratory distress syndrome, tension pneumothorax, tension pneumocephalus, etc.).

Lab values

• Known bleeding risk factors, including coagulation factor deficiency, or receiving anticoagulant therapy, INR\>3.0 or APTT \> 3 times normal or platelet count less than 50×10⁹/L;
• Severe hepatic or renal dysfunction (severe hepatic dysfunction refers to ALT or AST \> 3 times the upper limit of the normal range, severe renal dysfunction refers to serum creatinine Cr \>1.5 times the upper limit of the normal range);
• Baseline blood glucose of \<50 mg/dL (2.78 mmol/L) or \>400 mg/dL (22.20 mmol/L);

Other

• The oxygen required to maintain 95% of peripheral arterial oxygen saturation (SaO2) under the current medium-term management guidelines \> 3L/min;
• CT or MR suggests intracranial tumors (other than meningiomas) or other high-risk intracranial vascular malformations;

• Age 18\~80 years;
• Clinically diagnosed as acute large vessel occlusive ischemic stroke, suitable for and received endovascular treatment according to current clinical guidelines;
• The onset of stroke or the last normal time to the time of endovascular treatment ≤ 24 hours;
• Pre-stroke mRS score of 0 or 1;
• Baseline NIHSS score before endovascular treatment ≥ 6 points in the anterior circulation or ≥10 points in the posterior circulation;
• CTA, MRA, or DSA angiography before endovascular treatment confirmed occlusion of large vessels (internal carotid artery, middle cerebral artery M1 segment, basilar artery), consistent with symptoms and signs;
• The corresponding anterior circulation ASPECTS score or posterior circulation pc-ASPECTS score ≥ 6 points;
• The pontine midbrain index (PMI) of patients with acute basilar artery occlusion ≤3;
• Patients or their family members sign the informed consent form.