Remote Ischemic Conditioning for Acute Ischemic Stroke Treated with Mechanical Thrombectomy（RECAST-MT）

Inclusion Criteria:

1. Age≥18 years；

2. Acute ischemic stroke due to large vessel occlusion in the anterior circulation thatis not suitable for intravenous thrombolytic therapy, or has contraindications tointravenous thrombolytic therapy, or treated with intravenous thrombolytic therapywithout recanalization;

3. Large vessel occlusion confirmed by computed tomography angiography (CTA) ormagnetic resonance angiography (MRA), including the occlusion of the intracranialsegment of the internal carotid artery (ICA) and M1 segment of the middle cerebralartery (MCA), is the cause of symptoms, and mechanical thrombectomy is plannedwithin 24 hours from the time last known well;

4. Baseline score of the National Institutes of Health Stroke Scale (NIHSS) ≥ 6 points;

5. Patients or family members signed a written informed consent form.

Exclusion Criteria:

1. Imaging examination revealed the presence of multiple vascular supply areas ofcerebral infarction (such as the simultaneous presence of infarction in bothanterior and posterior circulation);

2. Absence of femoral artery pulsation, extremely difficult intravascular access, orextremely tortuous large vessels, which are expected to result in the inability toundergo timely endovascular treatment;

3. Difficult-to-control hypertension: continuous monitoring upon admission showssystolic blood pressure ≥180mmHg, or diastolic blood pressure ≥100mmHg;

4. Coma or lethargy patients (consciousness level score ≥2 in NIHSS);

5. Unable to obtain an accurate baseline NIHSS score;

6. Pre-stroke modified Rankin Scale (mRS) score >1;

7. Baseline ASPECTS score ≤5;

8. Presence of bleeding tendency, deficiency of coagulation factors, or oralanticoagulant therapy with INR > 3.0;

9. Baseline blood glucose <2.7mmol/L or >22.2mmol/L;

10. Baseline platelet count < 30*10^9/L;

11. Severe known renal impairment defined as requiring dialysis (hemodialysis orperitoneal dialysis), or if known creatinine clearance rate <30mL/min;

12. Cranial CT or MRI shows intracranial hemorrhage;

13. Cranial CT or MRI shows midline deviation and significant occupying effect;

14. Clinical history, previous imaging examinations, or clinical judgment suggestingintracranial tumors, arteriovenous malformations, or intracranial arterialdissection;

15. History of head injury in the past 3 months;

16. History of life-threatening allergy to contrast agents, nickel, titanium metal, ortheir alloys;

17. Pregnancy, if women of childbearing age have a positive urinary or serum β-humanchorionic gonadotropin (β-hCG) test or are breastfeeding；

18. The life expectancy of patients is less than 6 months, and they cannot be evaluatedwithin 3 months;

19. Limb deformity, soft tissue injury, or other conditions that affect theimplementation of distant ischemia adaptation therapy;

20. Participating in other ongoing clinical trials;

21. Other conditions that the investigators believe are not suitable for participationin this study.