Ultra-early Identification of Futile Recanalization After Reperfusion Therapy in Acute Ischemic Stroke Based on Cerebral Autoregulation Monitoring

Ki vehet részt

• Age ≥ 18
• Diagnosis of acute ischemic stroke caused by anterior circulation large vessel occlusion (intracranial internal carotid artery or M1 segment of the middle cerebral artery)
• National Institutes of Health Stroke Scale (NIHSS) score ≥ 6 at presentation
• Pre-stroke modified Rankin Scale (mRS) score ≤ 1
• Symptom onset ≤ 24 hours
• For patients with symptom onset within 6 hours: ASPECTS ≥ 6; for patients with symptom onset between 6 and 24 hours: age ≤ 80 years and ASPECTS ≥ 3
• Underwent mechanical thrombectomy and achieved successful recanalization (mTICI 2b-3)
• Patient or legally authorized representative provides written informed consent

Ki nem vehet részt

• Severe alcohol dependence or drug dependence
• Participation in another clinical drug or device study within the past 30 days
• Pre-procedural baseline imaging showing significant intracranial hemorrhagic transformation, intracranial arterial dissection, large chronic cerebral infarction, or intracranial metastasis from malignant tumors
• Known history of carotid sinus hypersensitivity syndrome, severe autonomic dysfunction, sick sinus syndrome, high-grade atrioventricular conduction block, or other malignant arrhythmias
• Refractory malignant hypertensive crisis (systolic blood pressure persistently ≥ 200 mmHg despite standardized intravenous antihypertensive therapy, or hemodynamic instability with shock)
• Known severe allergy to contrast agents or anesthetic drugs, or contraindications to antiplatelet/anticoagulation therapy
• Severe systemic active infection, multiple organ failure, or expected survival < 6 months
• Heart failure with NYHA class > II, or persistent systolic blood pressure < 100 mmHg
• Central nervous system infection or intracranial tumor
• Cognitive impairment or psychiatric disorders that may affect follow-up assessments
• Local skin damage or other conditions preventing proper placement of monitoring electrodes
• Severe agitation or other conditions that interfere with data acquisition
• Any other condition judged by investigators to potentially affect study results
• Severe hepatic or renal dysfunction (ALT/AST > 3× upper limit of normal; estimated glomerular filtration rate < 30 mL/min) or severe coagulation disorders (platelet count < 40 × 10⁹/L, APTT > 50 s, INR > 3.0)
• Blood glucose < 2.7 mmol/L or > 22.2 mmol/L
• Any degree of stenosis, plaque, dissection, severe tortuosity, or imaging evidence of unstable/vulnerable plaque in the target-side or bilateral common carotid artery or the origin of the internal carotid artery
• Unstable vital signs
• Pregnant or breastfeeding women