Methylprednisolone With Endovascular Thrombectomy for Large Ischemic Stroke

Más betegség

• 1. Intracranial hemorrhage confirmed by CT or MRI;
• 2. Allergic to glucocorticoids or placebo components;
• 3. Allergic to contrast agent;
• 4. Presence of severe infectious disease unsuitable for glucocorticoid therapy or any other contraindication to glucocorticoid use;
• 8. History of gastrointestinal or urinary tract bleeding within the last month;
• 12. Uncontrolled hypertension with persistent systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg, refractory to medical management;
• 13. Life expectancy less than 6 months due to malignancy or severe cardiopulmonary disease;
• 14. Other conditions deemed unsuitable for the study by the investigator, such as inability to comprehend or comply with study procedures or follow-up due to mental illness, cognitive or emotional disorder.

Laborértékek

• 5. Known genetic or acquired coagulopathy, coagulation factor deficiency, use of warfarin with an international normalized ratio (INR) >1.7, or use of novel oral anticoagulants within 48 hours of symptom onset;
• 6. Platelet count <90×10\^9/L;
• 7. Random blood glucose <2.8 mmol/L or >22.2 mmol/L;
• 11. Renal dysfunction (glomerular filtration rate <30 ml/min or serum creatinine >220 μmol/L [2.5 mg/dl]);

Egyéb

• 9. Current participation in another interventional clinical study;
• 10. Pregnant or lactating women;

• 1. Age ≥18 years;
• 2. Clinically diagnosed with acute ischemic stroke and NIHSS ≥6;
• 3. CT angiography (CTA), MR angiography (MRA) or digital subtraction angiography (DSA) confirmed occlusion of intracranial internal carotid artery (ICA) or M1/M2 segments of middle cerebral artery (MCA) and plan to undergo EVT;
• 4. ASPECTS ≤5 (based on NCCT) or infarct core volume ≥70mL (defined as rCBF <30% on CT perfusion or ADC <620 on MRI);
• 5. Time from symptom onset to randomization within 24 hours (from last known well);
• 6. Pre-stroke mRS score 0-2;
• 7. Written informed consent signed by patients or their family members.