The Efficacy and Safety of Endovascular Therapy for Acute Ischemic Stroke Due to Large Core Infarction

Prior treatment

• Any sign of intracranial hemorrhage (except microbleeds) on brain imaging prior to randomization
• Enrolled in another drug or device trial or expected to participate in another drug or device treatment trial within the following 3 months
• Acute cerebral infarction occurred within 48 hours after cardio cerebral vascular intervention or major surgery (patients over 48 hours can be included in the group)

Other illness

• History of contraindication for contrast medium (except mild rash)
• Refractory hypertension (defined as systolic blood pressure\>220 mmHg or diastolic blood pressure\>110 mmHg) that cannot be controlled by drug treatment;
• Known to have dementia or psychiatric disease unable to complete neurological assessment and follow-up
• It is known that patients with dementia or mental illness cannot complete neurological function assessment and follow-up
• Patients whose life expectancy is less than 1 year (such as patients with malignant tumor, advanced cardiopulmonary disease, etc.)
• Any other condition (in the opinion of the site investigator) that inappropriate to participate this study

Lab values

• Known hereditary or acquired bleeding tendency, lack of coagulation factors, or oral anticoagulants with INR\>1.7
• Blood glucose\<2.7 or\>22.2 mmol/L; Platelet count\<50×109/L, glomerular filtration rate\<30ml/min or serum creatinine ≥ 3 mg/dl

Other

• Complete cerebellar infarct with significant mass effect, or bilateral thalamic infarction as evidenced by baseline neuroimaging
• Known or highly suspected chronic occlusion of basilar artery
• Current pregnant or breast-feeding
• CTA/MRA/DSA confirmed occlusion of anterior and posterior circulation
• Central nervous system vasculitis has been diagnosed or clinically suspected

• The age ranged from 18 to 80 years
• Acute ischemic stroke in posterior circulation, the time from stroke onset (or finally found normal) to randomization was within 24 hours
• Acute basilar artery occlusion confirmed by CTA,MRA,or DSA
• Posterior circulation large core infarction:NCCT or DWI showed pc-ASPECTS≤5, or Pons-Midbrain Index (PMI)≥3
• NIHSS score ≥10 before randomization
• Pre-stroke mRS of 0-2
• Each patient or their legal representative must provide written informed consent before enrolment