A multicenter, prospective, open-label, blinded endpoint, randomized controlled trial aiming at evaluating the efficacy and safety of intra-arterial recombinant human tissue plasminogen activator (rt-PA) after successful recanalization of acute large vessel occlusion in the anterior circulation by mechanical thrombectomy in improving the 90-day functional outcome.
Aged 18 years or older.
Clinical diagnosis of acute ischemic stroke.
Time from symptom onset to randomization within 24 hours, including wake-up stroke or no-witness stroke; the onset time refers to "Last Known Well" (LKW).
CTA or MRA confirmed occlusion of the intracranial segment of the internal carotid artery, or M1 or M2 segment of the middle cerebral artery; stable eTICI score of 2b50-3 after mechanical thrombectomy, with or without intravenous thrombolysis. Patients with an eTICI score of 2b50-3 on the diagnostic cerebral angiography before mechanical thrombectomy are also eligible for the study.
Contraindication to rt-PA (except time to therapy).
Planned use of dual antiplatelet therapy within the first 24 hours after mechanical thrombectomy.
Angiographic evaluation showing dissection, severe stenosis, or complete occlusion of the carotid artery, which requires the use of carotid artery stents during the endovascular procedure.
Suspected cerebral vasculitis based on medical history and/or angiographic evaluation.
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Lead sponsor
Shenzhen Hospital of Southern Medical University
Collaborator