Combined Recanalization Therapy for Acute Large Vessel Occlusion Stroke

Inclusion criteria

• Age: 18-75.
• According to the current guidelines, there is a MT indication.
• Before stroke, mRS ≤2;
• ASPECTS ≥6;
• MCA occlusion, with or without ICA occlusion;
• MT unsuccessful, TICI score 0-1;
• Time from onset to craniotomy expected to be 24 hours or less;
• Post-awakening stroke with mismatch between the infarct zone and the penumbra zone;

Exclusion criteria

• Comorbid hemorrhagic vascular disease such as intracranial aneurysm or vascular malformation or other planned cerebrovascular surgery that may alter cerebral hemodynamics or lead to stroke;
• unstable angina or myocardial infarction, congestive heart failure within the previous 6 months;
• Pregnancy or perinatal period;
• Hematologic disorders resulting in coagulation disorders;
• Combination of other diseases with a life expectancy of less than 2 years; and
• previous treatment with intracranial or extracranial vascular bypass surgery;
• allergy to iodine or X-ray contrast media, creatinine >3.0 mg/dl or other contraindications to arteriography;
• Uncontrolled diabetes mellitus, fasting blood sugar (FBS) >16.7 mmol/L;
• Uncontrolled hypertension with sitting systolic blood pressure >180 mmHg or sitting diastolic blood pressure >110 mmHg;
• Severe hepatic dysfunction, defined as serum alanine aminotransferase (ALT) and/or alanine aminotransferase (AST) >3 times the upper limit of normal;
• Platelets <100×109 /L.
• Received a clinical trial drug or device within 30 days prior to screening, or is participating in another clinical trial;
• contraindication to general anesthesia or craniotomy;
• other diseases or medical history that, in the investigator's judgment, may affect the efficacy or safety evaluation of this study.