Methylprednisolone Adjunctive to Endovascular Thrombectomy for Stroke

Other illness

• Intracranial hemorrhage confirmed by cranial CT or MRI.
• Allergic to contrast agents or glucocorticoids.
• Bleeding history (gastrointestinal and urinary tract bleeding) in recent 1 month.
• Life expectancy due to any advanced disease \< 6 months.
• Systemic infectious disease.

Lab values

• Chronic hemodialysis and severe renal insufficiency (glomerular filtration rate \< 30 ml/min or serum creatinine \> 220 umol/L \[2.5 mg/ dL\]).

Other

• mRS score \> 2 before onset.
• Pregnant or lactating women.
• Participating in other clinical trials.
• The artery is tortuous so that the thrombectomy device cannot reach the target vessel.
• Follow-up is not expected to be completed.
• Intracranial aneurysm and arteriovenous malformation.
• Brain tumors with imaging mass effect.

• Age ≥ 18 years.
• The time from onset to randomization was within 12 hours.
• Anterior circulation ischemic stroke was preliminarily determined according to clinical symptoms or imaging examination.
• Occlusion of the intracranial internal carotid artery, the M1- or M2-segment of the middle cerebral artery by confirmed by CT angiography (CTA), MR angiography (MRA), or digital subtraction angiography (DSA).
• Baseline National Institutes of Health Stroke Scale (NIHSS) ≥ 6.
• Baseline Alberta Stroke Program Early CT Score (ASPECTS) \< 6 (based on non-contrast CT or MRI) and/or core infarct volume ≥ 50 ml (based on CTP with rCBF \< 30%).
• Planned treatment with endovascular thrombectomy (EVT).
• Informed consent obtained from patients or their legal representatives.