Phase 3, Randomized, Placebo-Controlled, Double-Blinded Trial of the Combined Lysis of Thrombus With Ultrasound and Systemic Tissue Plasminogen Activator (tPA) for Emergent Revascularization in Acute Ischemic Stroke

Inclusion Criteria

• •1. Males or females 18 - 80 years of age
• •2. Subjects presenting within timeframe for intravenous tPA treatment approved by local regulatory authorities but no more than 4.5 hours from onset of symptoms
• •3. No signs of intracranial bleeding on assessment by non-contrast CT
• •4. Subjects with neurological deficits of a total NIHSS score ≥ 10 points
• •5. Subjects that in the opinion of the treating physician require treatment with full dose IV tPA as standard of care per institutional standards
• •6. SBP \< 185 mmHg and DBP \< 105 mmHg at baseline or after treatment of hypertension with medications prior to tPA bolus
• •7. Pre-morbid modified Rankin score of 0-1
• •8. Provision of informed consent as demonstrated by the subject's signature or by the signature of the subject's authorized legal representative on the Informed Consent Form in accordance with all local and national regulations
• •9. Co-signature on the Informed Consent Form by a qualified member of the study staff signifying that, in his/her professional opinion, informed consent has been obtained in accordance with all local and national regulations
• •10. For subjects in the optional arterial recanalization substudy:
• •1. Occlusion located in the intracranial carotid tee through mid M2 or proximal A2, or intracranial vertebrobasilar or P1/proximal P2 segments or tandem lesions
• •2. Estimated glomerular filtration rate (eGFR) ≥ 60 mL/min for patients undergoing CTA or MRA