Minocycline After Successful Endovascular Thrombectomy Recanalization in Posterior Circulation Arterial Occlusion (ATTRACTION-MINOP)

Ki vehet részt

• Age ≥18 years
• Pre-stroke mRS score of 0-1
• Time from symptom onset to randomization ≤24 hours, including wake-up stroke or unwitnessed stroke. Symptom onset is defined as the last known well time
• Baseline NIHSS score ≥6
• Posterior Circulation ASPECTS ≥6 on non-contrast CT or DWI
• Clinical symptoms attributable to acute occlusion of the intracranial vertebral artery or basilar artery, confirmed by CTA, MRA, or DSA
• Successful recanalization defined as mTICI 2b-3 after mechanical thrombectomy, with no evidence of secondary embolization in non-target vessels; or spontaneous improvement to mTICI 2b-3 on diagnostic angiography prior to thrombectomy with no planned intervention
• Ability of the patient or legally authorized representative to provide written informed consent

Ki nem vehet részt

• Occlusion involving both anterior and posterior circulations on CTA, MRA, or DSA (except in patients with a prior history of anterior circulation occlusion)
• Known allergy to tetracycline antibiotics, any component of the investigational drug, radiocontrast agents, or nitinol materials
• Use of tetracycline antibiotics within 7 days prior to randomization
• Receipt of any of the following treatments within the past 3 months: systemic retinoic acid or androgen/antiandrogen therapy (e.g., anabolic steroids, spironolactone)
• Women who are pregnant or lactating, or who have a positive pregnancy test prior to randomization
• Acute intracranial hemorrhage on CT or MRI
• History of pseudomembranous colitis or antibiotic-associated colitis
• History of intracranial hemorrhage within the past 3 months, including intraparenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural hematoma, or epidural hematoma
• History of intracranial or spinal surgery within the past 3 months
• History of major surgery or significant trauma within the past 1 month
• Life expectancy <6 months (e.g., due to malignancy or severe cardiopulmonary disease)
• Any other condition that, in the investigator's judgment, makes the patient unsuitable for participation or poses significant risk (e.g., inability to understand or comply with study procedures or follow-up due to psychiatric, cognitive, or emotional disorders)
• Platelet count <100 × 10⁹/L
• Severe hepatic insufficiency, chronic hemodialysis, or severe renal insufficiency (defined as estimated glomerular filtration rate <30 mL/min or serum creatinine >265.2 μmol/L [3.0 mg/dL])
• Complete bilateral thalamic infarction or bilateral brainstem infarction on CT or MRI
• Cerebellar infarction with significant mass effect or compression of the fourth ventricle on CT or MRI
• Vascular anatomy on CTA, MRA, or DSA that is severely tortuous, demonstrates significant anatomical variation, or shows severe stenosis or dissection precluding navigation of thrombectomy devices to the target vessel
• Known resistance to tetracycline antibiotics
• Intracranial tumors, vascular malformations, or other space-occupying intracranial lesions
• Participation in another interventional clinical trial that may affect outcome assessment