Advancing Reperfusion Therapy for Ischemic Stroke: Perfusion-guided Endovascular Intervention for Medium Vessel Occlusion Therapy

Exclusion Criteria

• •Any evidence of intracranial hemorrhage on qualifying imaging;
• •Known (serious) sensitivity to radiographic contrast agents, nickel, titanium metals or their alloys and unable to complete CTP/PWI;
• •Known history of arterial tortuosity, pre-existing stent, other arterial disease and/or known disease at the arterial access site that would prevent the device from reaching the target vessel and/or preclude safe recovery after EVT;
• •Radiological confirmed evidence of mass effect or intracranial tumour (except small meningioma);
• •Clinical diagnosis of cerebral vasculitis;
• •Evidence of vessel recanalization prior to randomisation;
• •Severe comorbidities, which will likely prevent improvement or follow-up;
• •Any terminal illness such that the patient would not be expected to survive more than 1 year;
• •Hypodensity in \>1/3 MCA territory on non-contrast CT or significant hypodensity outside the current perfusion lesion suggesting distal clot migration (secondary MeVO);
• •Multiple arterial occlusion;
• •Pregnant women, nursing mothers, or reluctance to use effective contraceptive measures during the period of the trial;
• •Unlikely to adhere to the trial protocol or follow-up;
• •Participation in other interventional clinical trials within the previous 3 months.