Contact aspiration versus stent retriever thrombectomy for acute basilar artery occlusion (ANGEL-COAST): rationale and design of a multicentre, prospective, randomised, open-label, blinded-endpoint trial

接触抽吸与支架取栓治疗急性基底动脉闭塞（ANGEL - COAST）：一项多中心、前瞻性、随机、开放标签、盲法终点试验的原理与设计

Contact aspiration (CA) and stent retriever (SR) thrombectomy are two equally recommended first-line endovascular techniques for treating acute ischaemic stroke due to large vessel occlusion. Whether CA is more effective in achieving complete reperfusion compared with SR in patients with acute basilar artery occlusion (ABAO) remains unclear. This is a head-to-head randomised trial to directly compare CA and SR in ABAO. The findings will help establish the optimal first-line endovascular treatment strategy for ABAO, potentially improving clinical outcomes in this high-risk group.

接触抽吸（CA）和支架取栓器（SR）取栓术是两种同样被推荐用于治疗大血管闭塞所致急性缺血性卒中的一线血管内治疗技术。在急性基底动脉闭塞（ABAO）患者中，与SR相比，CA在实现完全再灌注方面是否更有效仍不清楚。这是一项直接比较CA和SR治疗ABAO的头对头随机试验。研究结果将有助于确定ABAO的最佳一线血管内治疗策略，有可能改善这一高危人群的临床结局。

REF: Xuan S, Yang M, Sun D, et al. Contact aspiration versus stent retriever thrombectomy for acute basilar artery occlusion (ANGEL-COAST): rationale and design of a multicentre, prospective, randomised, open-label, blinded-endpoint trial. Stroke Vasc Neurol. Published online October 28, 2025. doi:10.1136/svn-2025-004232 PMID: 41151802

Rationale and design of Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined with Endovascular Treatment in ACute Ischaemic StrokE (RETRACE II): a randomised double-blind controlled multicentre phase II pilot study

低频重复经颅磁刺激联合血管内治疗急性缺血性卒中的原理与设计（RETRACE II）：一项随机双盲对照多中心 II 期先导研究

While endovascular therapy (EVT) remains the primary treatment for acute ischaemic stroke (AIS) management, persistent functional deficits in patients with successful recanalisation underscore the necessity for complementary neuroprotective strategies. To investigate the safety and efficacy of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) as a potential adjunctive neuroprotective intervention following EVT in AIS patients. RETRACE-II establishes methodological rigour for evaluating neuromodulation therapies during the hyperacute stroke phase, with findings expected to inform future trials and advance combination therapy paradigms in cerebrovascular neuroprotection.

尽管血管内治疗（EVT）仍然是急性缺血性卒中（AIS）管理的主要治疗方法，但成功再通患者仍存在持续的功能缺陷，这凸显了采用补充性神经保护策略的必要性。旨在研究低频重复经颅磁刺激（LF - rTMS）作为AIS患者EVT后潜在辅助神经保护干预措施的安全性和有效性。RETRACE - II为评估超急性卒中阶段的神经调节疗法建立了严格的方法学，其研究结果有望为未来的试验提供参考，并推动脑血管神经保护联合治疗模式的发展。

REF: Ding L, Wang W, Yi T, et al. Rationale and design of Low-Frequency REpetitive TRanscranial Magnetic Stimulation Combined with Endovascular Treatment in ACute Ischaemic StrokE (RETRACE II): a randomised double-blind controlled multicentre phase II pilot study. Stroke Vasc Neurol. Published online October 28, 2025. doi:10.1136/svn-2025-004331 PMID: 40721316

Tenecteplase versus standard care in patients with acute basilar artery occlusion: a multi-centre, prospective, randomised, open-label, blinded endpoint, phase 3, controlled trial

替奈普酶对比标准治疗用于急性基底动脉闭塞患者：一项多中心、前瞻性、随机、开放标签、终点设盲的3期对照试验

There is a scarcity of evidence of tenecteplase administered within the 24-hour window of acute ischaemic stroke due to basilar artery occlusion (BAO). We sought to assess whether intravenous tenecteplase within 24 hours of stroke onset, with or without endovascular treatment (EVT), leads to superior outcomes compared with standard care in acute BAO. The TRACE-5 trial will address whether extended-time window thrombolysis with a potentially more effective thrombolytic agent tenecteplase±EVT is superior to standard care in BAO.

由于基底动脉闭塞（BAO）导致的急性缺血性卒中，在发病24小时内使用替奈普酶的相关证据十分匮乏。我们旨在评估在卒中发作后24小时内静脉注射替奈普酶，无论是否联合血管内治疗（EVT），与急性BAO的标准治疗相比是否能带来更优的预后。TRACE - 5试验将探讨在BAO中，使用潜在更有效的溶栓剂替奈普酶±EVT进行超时间窗溶栓治疗是否优于标准治疗。

REF: Xiong Y, Alemseged F, Cao Z, et al. Tenecteplase versus standard care in patients with acute basilar artery occlusion: a multi-centre, prospective, randomised, open-label, blinded endpoint, phase 3, controlled trial. Stroke Vasc Neurol. Published online October 28, 2025. doi:10.1136/svn-2025-004432 PMID: 41151803

Outcomes of Onyx embolisation as primary treatment for intracranial dural arteriovenous fistulas over the past two decades

过去二十年间，Onyx栓塞术作为颅内硬脑膜动静脉瘘主要治疗方法的疗效

Most current studies on Onyx are limited by small sample sizes and often involve its use in combination with other embolic materials, with few investigations specifically evaluating Onyx as a sole embolic agent. In this large single-centre study based on the DREAM-INI database, we report satisfactory obliteration rates, a low incidence of complications and favourable outcomes following Onyx-based single-agent primary embolisation for single DAVFs.

目前大多数关于Onyx的研究都受限于样本量较小，且这些研究往往涉及Onyx与其他栓塞材料联合使用，很少有研究专门评估Onyx作为单一栓塞剂的情况。在这项基于DREAM - INI数据库的大型单中心研究中，我们报告了以Onyx为单一药物对单一硬脑膜动静脉瘘进行初次栓塞治疗后取得的令人满意的闭塞率、较低的并发症发生率以及良好的预后情况。

REF: Su X, Song Z, Chen Y, Zhang H, Zhang P, Ma Y. Outcomes of Onyx embolisation as primary treatment for intracranial dural arteriovenous fistulas over the past two decades. Stroke Vasc Neurol. Published online October 28, 2025. doi:10.1136/svn-2025-004611 PMID: 41151804

Risk factors for cervical artery dissection: a systematic review with meta-analysis

颈动脉夹层的危险因素：一项系统评价与荟萃分析

Cervical artery dissection (CAD) is a rare cause of stroke. This is an update of an earlier systematic review, which focuses on the risk of CAD in the general population. The objective was to identify the risk factors for CAD. This is the first review that comprehensively examined the risk of CAD in the general population. Genetic factors, cardiovascular risk factors, recent infection and minor trauma are risk factors for CAD. Caution is needed in interpretation as the evidence is overall low to very low certainty, except for migraine and MTHFR TT homozygosity.

颈动脉夹层（CAD）是一种罕见的中风病因。这是对早期系统评价的更新，该早期评价聚焦于普通人群中CAD的发病风险。其目的是确定CAD的危险因素。这是首次全面审视普通人群中CAD发病风险的综述。遗传因素、心血管危险因素、近期感染和轻微创伤都是CAD的危险因素。由于总体证据的确定性为低到极低，解读时需谨慎，但偏头痛和亚甲基四氢叶酸还原酶（MTHFR）TT纯合子情况除外。

REF: Jacobs W, Wright DS, Pohlman K, et al. Risk factors for cervical artery dissection: a systematic review with meta-analysis. Stroke Vasc Neurol. Published online October 20, 2025. doi:10.1136/svn-2025-004186 PMID: 40866078

BEST-BAO: a multicentre, prospective, randomised controlled trial of endovascular treatment with or without intravenous thrombolysis in acute ischaemic stroke due to basilar artery occlusion – study protocol and rationale

BEST - BAO研究：一项关于基底动脉闭塞所致急性缺血性卒中血管内治疗联合或不联合静脉溶栓的多中心、前瞻性、随机对照试验——研究方案与原理

Endovascular treatment (EVT) is safe and effective in treating acute ischaemic stroke due to basilar artery occlusion (AIS-BAO); nonetheless, the impact of intravenous thrombolysis (IVT) on its efficacy remains unclear. The primary endpoint is the proportion of independent neurological function defined as a modified Rankin Scale score of 0 to 2 at 90±14 days after stroke onset.

血管内治疗（EVT）在治疗由基底动脉闭塞导致的急性缺血性卒中（AIS - BAO）方面安全有效；然而，静脉溶栓（IVT）对其疗效的影响仍不明确。主要终点是卒中发作后90±14天时改良Rankin量表评分为0至2分所定义的神经功能独立患者比例。

REF: Xiang Y, Yang S, Guo L, et al. BEST-BAO: a multicentre, prospective, randomised controlled trial of endovascular treatment with or without intravenous thrombolysis in acute ischaemic stroke due to basilar artery occlusion - study protocol and rationale. Stroke Vasc Neurol. Published online October 9, 2025. doi:10.1136/svn-2025-004144 PMID: 40953924

Predictors of futile recanalisation in patients with large infarct: a post-hoc analysis of the ANGEL-ASPECT trial

大面积梗死患者血管再通无效的预测因素：ANGEL - ASPECT试验的事后分析

Studies on futile recanalisation after endovascular therapy (EVT) for anterior circulation large vessel occlusion with large infarct were scarce. The present study aimed to explore the incidence and independent predictors of futile recanalisation in patients with large infarct. Futile recanalisation occurred in approximately half of patients who had an acute stroke with large infarct after EVT in the ANGEL-ASPECT trial. Nonmodifiable factors that included old age, high baseline NIHSS score, diabetes mellitus, sICH and large FIV, and modifiable factors that included respiratory failure were independent predictors of futile recanalisation after EVT for large ischaemic strokes. Stroke-related pneumonia control may improve prognosis.

关于大梗死灶的前循环大血管闭塞患者血管内治疗（EVT）后再通无改善情况的研究较少。本研究旨在探讨大梗死灶患者再通无改善的发生率及其独立预测因素。在ANGEL - ASPECT试验中，约半数大梗死灶急性卒中患者在血管内治疗后出现再通无改善情况。高龄、高基线美国国立卫生研究院卒中量表（NIHSS）评分、糖尿病、症状性颅内出血（sICH）和大面积梗死体积（FIV）等不可改变因素，以及呼吸衰竭等可改变因素，是大缺血性卒中血管内治疗后再通无改善的独立预测因素。控制卒中相关性肺炎可能改善预后。

REF: Yi T, Huo X, Lin X, et al. Predictors of futile recanalisation in patients with large infarct: a post-hoc analysis of the ANGEL-ASPECT trial. Stroke Vasc Neurol. Published online October 6, 2025. doi:10.1136/svn-2024-003382 PMID: 40623733

Association between elevated adiponectin levels and 5-year risk of clinical outcomes in patients with ischaemic stroke

缺血性脑卒中患者脂联素水平升高与临床结局5年风险的关联

The role of adiponectin (ADPN) in stroke remains debatable, despite its significant impact as a major adipocytokine on cardiovascular (CV) diseases. This study aimed to assess the association between ADPN and 5-year mortality, functional outcome and recurrence in Chinese individuals with first ischaemic stroke (IS). Elevated baseline ADPN levels were independently associated with increased 5-year non-CV mortality in Chinese IS patients, especially among those with mild neurological impairment. These findings suggest ADPN may serve as a prognostic biomarker for systemic vulnerability after stroke.

尽管脂联素（ADPN）作为一种主要的脂肪细胞因子对心血管（CV）疾病有重大影响，但其在中风中的作用仍存在争议。本研究旨在评估ADPN与中国首次缺血性中风（IS）患者5年死亡率、功能结局和复发情况之间的关联。在中国IS患者中，尤其是那些神经功能轻度受损的患者，基线ADPN水平升高与5年非心血管死亡率增加独立相关。这些研究结果表明，ADPN可能作为中风后全身脆弱性的预后生物标志物。

REF: Chen S, Lin F, Yin J, et al. Association between elevated adiponectin levels and 5-year risk of clinical outcomes in patients with ischaemic stroke. Stroke Vasc Neurol. Published online October 6, 2025. doi:10.1136/svn-2024-003517 PMID: 41057170