A Multicenter Study Comparing Intra-arterial Thrombolysis Plus Best Medical Treatment Versus Best Medical Treatment Alone for Acute Ischemic Stroke Caused by Medium Vessel Occlusion or Severe Stenosis

What this Trial Is About

Researchers are evaluating intra-arterial thrombolysis as a treatment for adults who have an acute ischemic stroke caused by medium vessel occlusion MeVO or severe artery narrowing. This trial aims to determine the safety and effectiveness of this treatment compared to standard medical care alone. The study addresses the current lack of strong evidence supporting intra-arterial thrombolysis in this specific type of stroke, building on previous trials that showed no clear benefit of endovascular therapy for MeVO. Participants will be randomly assigned to one of two groups. One group will receive the best medical treatment along with intra-arterial thrombolysis using Tenecteplase rhTNK-tPA, administered directly into the artery near the blockage for 5 to 30 minutes. The other group will receive the best medical treatment alone as recommended by stroke care guidelines. The decision to continue thrombolysis beyond the initial 5 minutes is guided by imaging during the procedure. Throughout the study, participants will be monitored for recovery and safety outcomes. The primary measure will be the level of disability 90 days after treatment, using the modified Rankin Scale. Additional assessments include neurological improvements or deterioration within 24 hours and overall functional independence. The trial is designed to carefully track patient progress and adverse events to evaluate the treatments impact over time.

Intra-arterial Thrombolysis for Acute Ischemic Stroke With Medium Vessel Occlusion