Prognostic Biomarkers for Selective Intra-Arterial Cooling Infusion Combined with Endovascular Thrombectomy in Acute Ischemic Stroke Based on Proteomics and Metabolomics.

Inclusion criteria

• Age ≥18 and ≤80.
• Clinical signs consistent with acute ischemic stroke with large vessel occlusion in the anterior circulation (intracranial segment of the internal carotid artery, middle cerebral artery M1 segment) demonstrated with CTA/MRA/DSA.
• NIHSS score obtained prior to randomization ≥6 and ≤25.
• Modified Rankin Scale ≤ 1 prior to qualifying stroke.
• Arterial puncture performed within 24 hours from symptom onset or LKW.
• For the patients with symptom onset within 6 hours, the ASPECT score ≥6; for the patientswith onset within 6-24 hours, the therapy should meet the imaging criteria of DAWN or DEFUSE-3 trial.
• Patient/Legally Authorized Representative has signed the Informed Consent Form.

Exclusion criteria

• Baseline CT/MRI confirms the presence of multiple vascular territory acute strokes.
• Baseline CT/MRI confirms the presence of arterial dissection.
• Evidence of intracranial hemorrhage or hemorrhagic transformation before thrombectomy.
• Known allergies or intolerances to antiplatelet agents, anticoagulation drugs, iodinated contrast and/or anesthetics.
• Severe infection (e.g. sepsis) or multiple organ failure.
• Known hereditary or acquired hemorrhagic diathesis, coagulation factor deficiency; recent oral anticoagulant therapy with INR > 3. Patients on factor Xa inhibitor for 48 hours ago must have a normal APTT.
• Baseline platelet count <50 × 109/L.
• Blood glucose concentration<50 mg/dL (2.7mmol/L) or >400 mg/dL (22.2mmol/L).
• Refractory hypertension that is difficult to control by medication (Defined as persistent systolic blood pressure>185 mmHg or diastolic blood pressure>110mmHg).
• Previous NHYA>1.
• Untreated moderate or severe coronary artery stenosis, or previous coronary artery bypass surgery.
• Undergoing hemodialysis or peritoneal dialysis; known severe renal insufficiency with glomerular filtration rate <30 ml/min or serum creatinine >220 mmol/L (2.5mg/dl).
• Known intracranial aneurysm, and cerebral arteriovenous malformation.
• Malignant brain tumor or CNS infection.
• Pre-existing neurological or psychiatric disease that would confound the neurological or functional evaluations (e.g., dementia or mental illness)
• Female who is pregnant or lactating at time of admission.
• Anticipated life expectancy <6 months.
• Current participation in another investigational drug or device study.
• For other reasons, the responsible clinicians believe that the patient is not suitable for continued treatment.