Pro-urokinase for Extended-Window Posterior Circulation Stroke

Korábbi kezelés

• Intracranial or spinal cord surgery within 3 months;
• Heparin therapy within 24 hours;
• Oral anticoagulation therapy;
• Major surgery within 1 month;
• Gastrointestinal or urinary tract hemorrhage within the previous 30 days;
• Participation in other interventional clinical trials within the previous 3 months.

Más betegség

• Subarachnoid or intracranial hemorrhage;
• History of intracranial hemorrhage;
• Active internal hemorrhage;
• Neurological deficit after epileptic seizures;
• Myocardial infarction within 3 months;
• Allergy to study drugs;
• Any condition that, in the judgment of the investigator could impose hazards to the patient if study therapy is initiated or affect the participation of the patient in the study;

Laborértékek

• platelet count of <100000/mm3;
• Oral warfarin is being taken and INR>1.6 or APTT abnormal;
• Blood glucose < 50 mg/dl (2.7mmol/L);

Egyéb

• Planned endovascular treatment;
• Contradictory to MRI examination;
• MRI image not qualified for evaluation;
• Serious neurological deficits before onset (mRS≥2);
• Obvious head injuries or strokes within 3 months;
• Intracranial tumor, arteriovenous malformation or aneurysm;
• Aortic arch dissection;
• Systolic pressure≥185 mmHg or diastolic pressure≥110 mmHg;
• Pregnancy;
• Unlikely to adhere to the trial protocol or follow-up;

• Age ≥ 18 years;
• AIS with symptom onset 4.5-9 hours before enrollment, including wake-up stroke and unwitnessed stroke (onset time defined as when symptoms were first noticed);
• Imaging criteria:
  • DWI-FLAIR mismatch: visible lesion on DWI with no marked visible lesion on FLAIR;
  • DWI infarct core not exceeding one-third of the middle cerebral artery territory, one-half of the anterior cerebral artery territory, or one-half of the posterior cerebral artery territory;
• NIHSS score 4-25;
• First-ever stroke or previous stroke without significant disability (pre-stroke mRS ≤ 1);
• Signed informed consent from the patient or legally authorized representative.