Efficacy and Safety of Tenecteplase Bridging Mechanical Thrombectomy for Acute Large Vessel Occlusion Stroke

Exclusion Criteria

• •1. Patients diagnosed with hemorrhagic stroke (including intraparenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural/extradural hematoma, etc.) or other related conditions identified by CT.
• •2. Contraindication to imaging examinations involving contrast agent injection.
• •3. Patients presenting with clinical symptoms of coma (NIHSS Score Item 1a = 3).
• •4. History of intracranial hemorrhage.
• •5. History of severe head trauma or stroke within the past 3 months.
• •6. Intracranial or intraspinal surgery within the past 3 months.
• •7. Major surgery within the past 2 weeks.
• •8. Gastrointestinal or urinary tract bleeding within the past 3 weeks.
• •9. Intracranial tumor, arteriovenous malformation, or giant intracranial aneurysm.
• •10. Active visceral bleeding.
• •11. Aortic arch dissection.
• •12. Arterial puncture at a non-compressible site within the past week.
• •13. Uncontrolled hypertension despite active antihypertensive treatment: Systolic Blood Pressure \> 180 mmHg or Diastolic Blood Pressure \> 100 mmHg.
• •14. Acute hemorrhagic tendency, including platelet count \< 100 × 10⁹/L or other conditions.
• •15. Heparin treatment received within the past 24 hours.
• •16. For patients on oral anticoagulants: INR \> 1.7 or PT \> 15 seconds.
• •17. Use of direct thrombin inhibitors or direct Factor Xa inhibitors within the past 48 hours.
• •18. Blood glucose \< 2.8 mmol/L or \> 22.2 mmol/L.
• •19. Hypodensity affecting \> 1/3 of the middle cerebral artery territory or an equivalent proportion of the basilar artery territory on non-contrast CT.
• •20. Rapidly improving symptoms as determined by the investigator.
• •21. Participation as a subject in another research study within the past 30 days.
• •22. Any terminal illness where life expectancy is considered not to exceed 1 year.
• •23. Any condition where, in the judgment of the investigator, the study treatment might pose a risk to the patient or affect the patient's participation in the study.
• •24. Pregnant women.
• •25. Known allergy to the active ingredients (Alteplase, Tenecteplase) or any excipients.