Efficacy and Safety of Plasma Adsorption Combined With EVT for AIS-LVO

Prior treatment

• Previous history of organic heart disease and NYHA Class III or IV.
• Current or past participation in other clinical research, or participation in this study within 3 months prior to admission.

Other illness

• Imaging after EVT indicated malignant brain edema with midline shift or brain herniation and surgical treatment was planned.
• Parenchymal hemorrhage type 1, or type 2 confirmed by CT.
• Allergic to any ingredient of the plasma separator, the adsorption device, or the piping.
• Previous history of malignant tumors, autoimmune diseases or being treated with immunosuppressants, hormones, or tumor necrosis factor inhibitors.
• Other conditions that the researchers think make the patient unsuitable for the study.

Lab values

• Contraindications to plasma adsorption, platelet count \<60×10\^9/L,white blood cell\<4×10\^9/L, uncontrolled hypertension with persistent systolic blood pressure ≥200 mmHg or diastolic blood pressure ≥110 mmHg, uncontrolled hypotension, systolic blood pressure \<90 mmHg or diastolic blood pressure \<60 mmHg.
• Currently taking anticoagulant(dabigatran, rivaroxiban, warfarin, etc.), previous history of serious hematological system disorders, or abnormal coagulation function (international normalized ratio \[INR\], activated partial thromboplastin time \[APTT\], prothrombin time \[PT\] upper limit of the normal range).
• Severe liver and kidney dysfunction or abnormal laboratory test results（serum aspartate aminotransferase or alanine aminotransferase \>3 times the upper limit of normal, serum creatinine\>265umol/l(\>3mg/dl)）.

Other

• Pregnancy , lactation or life expectancy of less than 3 months or inability to complete the study for other reasons.
• Unwilling to be followed up or poor compliance.

• Age 18-80 years, male or female.
• Diagnosis of acute ischemic stroke within 12 hours of symptom onset, underwent endovascular thrombectomy (EVT) adhering to current guidelines for large vessel occlusion in the anterior circulation (confirmed by DSA as ICA,MCA-M1,MCA-M2,ACA-A1,ACA-A2 occlusion or tandem lesion) and achieve successful recanalization (mTICI grade 2b/3).
• Baseline NIHSS after EVT ≥ 6 and ≤25 points.
• Randomization and the first plasma adsorption can be initiated within 12 hours after EVT.
• Pre-stroke mRS≤ 2 points.
• Patient/legally family members have signed the Informed consent form.