Intra-arterial Thrombolysis After Successful Thrombectomy for Acute Ischemic Stroke in the Posterior Circulation (IAT-TOP)

Exclusion Criteria

• •1. Contraindication to Intravenous Thrombolysis (except time to treatment);
• •2. Complete clinical recovery in the angiography suite by end of MT procedure;
• •3. More than 3 passes of thrombectomy device;
• •4. Dissection of occluded artery or intraoperative bleeding on DSA after thrombectomy;
• •5. Patients in sedation and intubated patients could not be included if baseline NIHSS is not obtained by a neurologist or emergency physician prior to sedation or intubation;
• •6. Seizures at stroke onset which would preclude obtaining a baseline NIHSS;
• •7. Bilateral dilated pupils;
• •8. Severe contrast allergy or absolute contraindication to iodinated contrast;
• •9. Systolic pressure \>185 mmHg or diastolic pressure \>110 mmHg, and cannot be controlled by antihypertensive drugs;
• •10. Blood glucose \<50 mg/dl (2.8 mmol/L) or \>400 mg/dl (22.2 mmol/L);
• •11. Platelet \<50\*10\^9/L, or aPTT \>40 s, or PT \>15 s;
• •12. Known genetic or acquired bleeding diathesis, deficiency of anticoagulant factors, or oral anticoagulant drugs and INR \> 1.7, or treated with direct oral anticoagulant agents in the prior 48 hours;
• •13. Known Severe renal Failure as defined by a serum creatinine \> 3.0 mg/dl (or 265.2 μmol/l) or glomerular Filtration Rate \[GFR\] \<30, or patient requires hemodialysis or peritoneal dialysis;
• •14. Patients that cannot complete 90-day follow-up (e.g. no fixed residence, overseas patients, etc.);
• •15. Presumed vasculitis or septic embolization;
• •16. Suspicion of aortic dissection;
• •17. The patient has neurological disease or mental disorder before onset, which affects the assessment of the condition;
• •18. Females who are pregnant or in lactation;
• •19. Participating in other clinical trials that could confound the evaluation of the study;
• •20. Other circumstances that the investigator considers inappropriate for participation or may pose a significant risk to patients.