Bailout Intracranial Angioplasty or Stenting After Thrombectomy for Acute Large Vessel Occlusion: 1-Year Outcomes of ANGEL-REBOOT

作者：Feng Gao, Xu Tong, Ming Wei, Xiaoxi Yao, Lei Li, Yuesong Pan, Baixue Jia, Thanh N. Nguyen, Ming Yang, Dapeng Sun, Guangyue Feng, Guangxiong Yuan, Chenghua Xu, Zhengzhou Yuan, Yue Wan, Jing Wang, Ping Jing, Xinguang Yang, Zhilin Wu, Wei Hu, Yuanfei Jiang, Chaobin Wang, Changming Wen, Jianjun Tang, Xiang Luo, Yingchun Wu, Ruile Shen, Tuanyuan Zheng, Yaxuan Sun, Mingze Chang, Yan Liu, Yang Haihua, Di Li, Bo Yin, Weihua Jia, Dongjun Wan, Guodong Xu, Zaiyu Guo, Dianjing Sun, Yang Wang, Jixin Duan, Liyu Wang, Guoqing Wang, Liping Wei, Gaoting Ma, Xiaochuan Huo, Dapeng Mo, Ning Ma, Zeguang Ren, Liping Liu, Xingquan Zhao, Yilong Wang, Jens Fiehler, Yongjun Wang, Zhongrong Miao, on behalf of the ANGEL-REBOOT Study Group · 发表于：Circulation · 年份：2025 · DOI：10.1161/circulationaha.125.075429 · 被引用次数：5 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Intracranial Aneurysms: Treatment and Complications

BACKGROUND: The long-term benefits of bailout intracranial angioplasty or stenting (BAOS) after thrombectomy in patients with acute large vessel occlusion remain unclear. This study compared BAOS with standard therapy in patients with large vessel occlusion with unsuccessful recanalization (expanded Thrombolysis In Cerebral Infarction score 0–2a) or >70% residual stenosis after thrombectomy. METHODS: ANGEL-REBOOT (Randomized Study of Bailout Intracranial Angioplasty Following Thrombectomy for Acute Large Vessel Occlusion) was a multicenter, open-label, blinded–end point, randomized trial conducted across 36 Chinese hospitals. Patients ≥18 years of age with anterior or posterior circulation large vessel occlusion within 24 hours of stroke onset were enrolled. After identification of thrombectomy failure or high-grade residual stenosis, patients were randomly assigned to the BAOS group (intervention) or the standard therapy group (control), in which thrombectomy was continued or terminated. The use of tirofiban was permitted in both groups during and after the procedure. In the intention-to-treat population, the primary outcome was analyzed using an assumption-free ordinal analysis (Wilcoxon-Mann-Whitney test) to compare the modified Rankin Scale scores (ordinal variable ranging from 0 to 6) between groups at 1-year follow-up, from which the generalized odds ratio was derived. Secondary outcomes included stroke recurrence in the treated artery and all-cause mortality within ...