Efficacy and Safety of Intra-arterial Tenecteplase in Acute Ischemic Stroke Patients With Medium Vessel Occlusion Stroke (DATE-MeVO)

Exclusion Criteria

• •1. Intracranial hemorrhage confirmed by cranial CT or MRI;
• •2. Already received intravenous thrombolysis;
• •3. Planned mechanical thrombectomy;
• •4. Intraoperative DSA showing vessel rupture, dissection, or contrast agent extravasation;
• •5. Pregnant or breastfeeding women;
• •6. Allergy to contrast agents or tenecteplase;
• •7. Systolic blood pressure \> 185 mmHg or diastolic blood pressure \> 110 mmHg, and failure to control with oral antihypertensive medications;
• •8. Genetic or acquired bleeding disorders, coagulation factor deficiencies; coagulation dysfunction, INR \> 1.7, or use of novel oral anticoagulants within 48 hours;
• •9. Blood glucose \< 2.8 mmol/L (50 mg/dL) or \> 22.2 mmol/L (400 mg/dL), platelet count \< 100 × 10\^9/L;
• •10. History of bleeding within the past month (gastrointestinal or urinary tract bleeding);
• •11. Chronic hemodialysis or severe renal insufficiency (glomerular filtration rate \< 30 mL/min or serum creatinine \> 220 μmol/L (2.5 mg/dL));
• •12. Severe mental disorders or inability to provide informed consent and comply with follow-up due to dementia;
• •13. Concurrent malignant tumors or severe systemic diseases with an expected survival time of less than 90 days;
• •14. Intracranial aneurysms or arteriovenous malformations;
• •15. Participation in another clinical interventional trial within 30 days prior to randomization or currently participating in another clinical interventional trial;
• •16. Occlusions in multiple vascular territories confirmed by CTA/MRA;
• •17. Other reasons that the investigator deems inappropriate for participation in the trial