Efficacy of Semaglutide in Improving Neurological Outcomes After Endovascular Thrombectomy for Acute Ischemic Stroke: A Randomized Double-Blind Controlled Trial

Acute ischemic stroke (AIS) is a condition associated with high rates of disability and mortality worldwide, and its incidence continues to rise in our country. Endovascular thrombectomy (EVT), a major advance in stroke treatment in recent years, has gained widespread clinical application and become a standard treatment for AIS caused by large-vessel occlusion. EVT significantly improves neurological functional outcomes. However, in clinical practice, despite successful recanalization of the occluded artery, nearly half of patients do not achieve a favorable prognosis. There is a compelling need to identify novel neuroprotective strategies to enhance the effectiveness of EVT and improve patient quality of life.

Recent evidence indicates that semaglutide reduces neuroinflammation and is associated with a decreased risk of stroke and fewer neurological complications in patients with diabetes. We anticipate that this trial will provide valuable insights into the potential role of semaglutide as a neuroprotective agent in patients with ischemic stroke.

Inclusion criteria

• Clinical or imaging diagnosis of acute ischemic stroke within 24 hours after onset;
• Scheduled for endovascular thrombectomy;
• Age ≥18 years;
• Pre-stroke modified Rankin Scale (mRS) score ≤1;
• Informed consent voluntarily signed by the patient or legal representative.

Exclusion criteria

• Preoperative imaging diagnosis of intracranial hemorrhage, or history of intracranial hemorrhage within 3 months prior to surgery;
• Contraindications for endovascular thrombectomy;
• Recent history of ischemic stroke;
• Fasting blood glucose <3.9 mmol/L;
• ASA classification of IV-V;
• Severe organic heart disease or severe arrhythmia;
• Pregnant or lactating women;
• Contraindications to semaglutide or allergy to semaglutide.