{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:31:55Z","timestamp":1793727115306,"version":"4.6.1"},"reference-count":16,"publisher":"BMJ","issue":"8","funder":[{"name":"Tianjin Health Science and Technology Project.","award":["MS20015"],"award-info":[{"award-number":["MS20015"]}]},{"name":"Tianjin Health Science and Technology Project.","award":["TJWJ2024ZD006"],"award-info":[{"award-number":["TJWJ2024ZD006"]}]},{"name":"Beijing-Tianjin-Hebei Basic Research Cooperation Project.","award":["22JCZXJC00190"],"award-info":[{"award-number":["22JCZXJC00190"]}]},{"name":"Tianjin Key Research and Development Program in Science and Technology.","award":["19YFZCSY00260"],"award-info":[{"award-number":["19YFZCSY00260"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82201618"],"award-info":[{"award-number":["82201618"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Health Commission Capacity Building and Continuing Education Center Nervous System and Minimally Invasive Intervention Program.","award":["GWJJ2022100106"],"award-info":[{"award-number":["GWJJ2022100106"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2025,8,18]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endovascular therapy within 24 hours of stroke onset is effective and safe, but successful recanalization does not always give favorable outcomes. Ischemic postconditioning (IPostC), a reperfusion strategy with potential neuroprotective effects, has been extensively studied in preclinical models, but its impact in humans remains unclear. Building on a previous dose escalation study, we aimed to investigate the effect of in situ IPostC on infarct volume in patients with acute ischemic stroke following mechanical thrombectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, externally controlled, non-randomized trial compared in situ IPostC (four cycles of 2\u2009min of occlusion\/2\u2009min of release) plus thrombectomy with contemporaneous external controls receiving thrombectomy alone. Propensity score matching (PSM) minimized selection bias. The primary outcome was infarct volume at 72 hours post-thrombectomy. Deep infarct volume was also compared in post hoc analyses. Peripheral blood was collected 24 hours post-procedure to assess leukocyte populations, with mononuclear cell subsets characterized by flow cytometry. Serum inflammatory biomarkers were also measured in both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After 1:1 PSM, 19 patients per group were analyzed. The IPostC group showed significantly less deep infarct volume progression (median 2.3 vs 4.7\u2009mL; P=0.045), lower interleukin 6 levels (median 26.4 vs 32.6\u2009pg\/mL; P=0.032), higher Th\/CTL ratios (median 2.04 vs 1.65; P&lt;0.01), and reduced natural killer cell proportions (median 1.10% vs 1.68%; P=0.047).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In situ IPostC following thrombectomy for large vessel occlusion stroke may be associated with reduced deep infarct volume progression and favorable immunomodulatory effects, warranting further validation in phase II trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05153655\">NCT05909982<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnis-2025-024031","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T07:55:13Z","timestamp":1756713313000},"page":"1757-1764","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["In situ ischemic postconditioning for acute ischemic stroke: preliminary exploratory 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2754-6049","authenticated-orcid":false,"given":"Shuling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-8629-201X","authenticated-orcid":false,"given":"Yongbo","family":"Xu","sequence":"additional","affiliation":[{"name":"Huanhu Hospital Affiliated to Tianjin Medical University, Tianjin Medical University, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6524-4028","authenticated-orcid":false,"given":"Bohao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sifei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4843-5225","authenticated-orcid":false,"given":"Leilei","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7141-6394","authenticated-orcid":false,"given":"Wenbo","family":"Zhao","sequence":"additional","affiliation":[{"name":"Neurology, Xuanwu Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8925-0687","authenticated-orcid":false,"given":"Yang","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tianjin 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