机构：[1]Interventional Neuroradiology, Capital Medical University, Beijing, China.[2]Department of Neurosurgery, Tianjin Huanhu Hospital, China[3]Department of Neurology, The First People's Hospital of Chenzhou, China[4]China National Clinical Research Center for Neurological Diseases, Beijing, China[5]Departments of Radiology and Neurology, Boston Medical Center, MA[6]Department of Emergency, Xiangtan Central Hospital, China[7]Department of Neurology, The First People's Hospital of Taizhou, China[8]Department of Neurology, The Affiliated Hospital of Southwest Medical University, Luzhou, China[9]Department of Neurology, The Third People's Hospital of Hubei Province, Wuhan, China[10]Department of Neurointerventional Radiology, Beijing Fengtai You'anmen Hospital, China[11]Department of Neurology, Wuhan Central Hospital, China[12]Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China中山大学附属第二医院[13]Department of Neurointerventional Radiology, YunFu People's Hospital, China[14]Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China[15]Department of Neurology, Tai'an Hospital of Chinese Medicine, China[16]Department of Neurology, Beijing Liangxiang Hospital, China[17]Department of Neurology, Nanyang Central Hospital, China[18]Department of Neurology, Shanghai Neuromedical Center, China[19]Department of Neurology, Tongji Hospital, Tongji Medical College of HUST, Wuhan, China华中科技大学同济医学院附属同济医院[20]Department of Neurology, Ordos Central Hospital, China[21]Department of Neurology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China[22]Department of Neurology, JiuJiang First People's Hospital, China[23]Department of Neurology, Shanxi Provincial People's Hospital, Taiyuan, China山西省人民医院[24]Department of Neurology, Xi'an Third Hospital, The Affiliated Hospital of Northwest University, China[25]Department of Neurology, JingJiang People's Hospital, The Seventh Affiliated Hospital of Yangzhou University, JingJiang, China[26]Department of Neurology, Beijing Daxing People's Hospital, China[27]Department of Neurointerventional Radiology, Dalian Municipal Central Hospital, Dalian Medical University, China大连市中心医院[28]Department of Neurosurgery, The Second Affiliated Hospital of Wenzhou Medical University, China[29]Department of Neurology, Beijing Shijingshan Hospital, China[30]Department of Neurology, The 940th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Lanzhou, China[31]Department of Neurointerventional Radiology, Hebei Provincial People's Hospital, Shijiazhuang, China[32]Center for Neurology, Tianjin TEDA Hospital, China[33]Department of Neurointerventional Radiology, Yantai Mountain Hospital of Yantai City, China[34]Beijing Tiantan Hospital, Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.北京朝阳医院首都医科大学附属天坛医院[35]Department of Neurosurgery, Changsha Hospital of Traditional Chinese Medicine, China[36]Department of Neurointerventional Radiology, Beijing Shunyi Hospital, China[37]Department of Neurology, Binzhou People's Hospital, China[38]Department of Neurology, Luoyang Central Hospital, China[39]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.神经科系统神经内科首都医科大学宣武医院[40]Neurological Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.首都医科大学附属安贞医院[41]Department of Neurology, Capital Medical University, Beijing, China.[42]Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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.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 1 year, analyzed using Cox proportional hazards models.A total of 348 patients were randomly assigned (176 to the BAOS group and 172 to the standard therapy group) and followed for 90 days, from December 19, 2021, to June 2, 2023. Of these, 326 patients (166 in the BAOS group and 160 in the standard therapy group) completed the 1-year follow-up. Compared with standard therapy, BAOS significantly improved the 1-year modified Rankin Scale score distribution (generalized odds ratio, 1.34 [95% CI, 1.05-1.73]; P=0.02). Fewer stroke recurrences in the treated artery occurred in the BAOS group than in the standard therapy group (7 of 166 [4%] versus 21 of 160 [13%]; hazard ratio, 0.30 [95% CI, 0.13-0.71]; P=0.006). One-year mortality rates were similar between groups (25 of 166 [15%] versus 27 of 160 [17%]; hazard ratio, 0.87 [95% CI, 0.50-1.50]).Among Chinese patients with large vessel occlusion with unsuccessful recanalization or high-grade residual stenosis after thrombectomy, BAOS was associated with reduced disability and stroke recurrence after 1 year compared with standard therapy.URL: https://www.clinicaltrials.gov; Unique identifier: NCT05122286.
基金：
Funding provided by the National Natural Science Foundation of China (grant 62272325), Beijing Natural Science Foundation (grant Z220016), Beijing Hospitals authority ascent plan (grant DFL20240505), Noncommunicable Chronic Diseases-National Science and Technology major project (grants 2023ZD0505400, 2023ZD0505404, 2023ZD0505600, and 2023ZD0505603), Beijing Municipal Administration of Hospitals incubating program (grant PX2023022), and Shanghai HeartCare Medical Technology, HeMo (China) Bioengineering, Sino Medical Sciences Technology.
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2025]版：
大类|1 区医学
小类|1 区心脏和心血管系统1 区外周血管病
最新[2025]版：
大类|1 区医学
小类|1 区心脏和心血管系统1 区外周血管病
第一作者：
第一作者机构：[1]Interventional Neuroradiology, Capital Medical University, Beijing, China.
共同第一作者：
通讯作者：
通讯机构：[4]China National Clinical Research Center for Neurological Diseases, Beijing, China[41]Department of Neurology, Capital Medical University, Beijing, China.
推荐引用方式(GB/T 7714)：
Gao Feng,Tong Xu,Wei Ming,et al.Bailout Intracranial Angioplasty or Stenting After Thrombectomy for Acute Large Vessel Occlusion: 1-Year Outcomes of ANGEL-REBOOT[J].Circulation.2025,doi:10.1161/CIRCULATIONAHA.125.075429.
APA：
Gao Feng,Tong Xu,Wei Ming,Yao Xiaoxi,Li Lei...&Miao Zhongrong.(2025).Bailout Intracranial Angioplasty or Stenting After Thrombectomy for Acute Large Vessel Occlusion: 1-Year Outcomes of ANGEL-REBOOT.Circulation,,
MLA：
Gao Feng,et al."Bailout Intracranial Angioplasty or Stenting After Thrombectomy for Acute Large Vessel Occlusion: 1-Year Outcomes of ANGEL-REBOOT".Circulation .(2025)
医学