Endovascular Treatment Combined with Remote Ischemic Postconditioning in Patients with Acute Ischemic Stroke Improves the Prognosis,a Multicenter, Randomized, Prospective Trial(EnTRIPS): study protocol for a randomized clinical trial

Endovascular therapy is a crucial treatment for patients with acute ischemic stroke(AIS), however many individuals experiencing cerebral ischemia-reperfusion (I/R) injury experience poor prognosis. Improving the clinical effectiveness of endovascular therapy remains a major clinical challenge, particularly in enhancing neuroprotection. Remote ischemic postconditioning (RIPC) has demonstrated potential in improving outcomes for AIS patients, especially those undergoing intravenous thrombolysis. However, the specific neuroprotective effects of RIPC in patients who have successfully undergone endovascular recanalization remain unexplored. This study aims to assess the safety and efficacy of RIPC in patients receiving endovascular therapy with successful recanalization. In this multicenter study, AIS patients from several tertiary hospitals who underwent endovascular therapy with successful recanalization were randomly divided into the RIPC group or control group. The RIPC group received postoperative distal ischemia adaptation twice daily until discharge for at least 7 days, while the control received standard care without RIPC intervention. The primary outcome measure was the proportion of patients achieving a favorable outcome (mRS [≤] 2) at 3 months post-surgery. We hypothesize that integrating RIPC with endovascular therapy will significantly enhance the functional prognosis of AIS patients, potentially leading to better functional prognosis.