Rescue Thrombolysis for Medium Vessel Occlusion (RESCUE-TNK)

Inclusion criteria

• Age ≥18 years;
• Medium vessel occlusion (MeVO), referring to M2-3 of MCA; A1-3 of ACA; P1-3 of PCA; PICA, AICA or SCA (including primary, distal embolism in the same region after thrombectomy or concurrent embolism in other regions).

• Primary MeVO as detected by the first DSA examination or secondary MeVO after mechanical thrombectomy for large vessel occlusion;
• MeVO causes neurological deficits in motor strength, language, vision etc;
• Endovascular mechanical thrombectomy cannot be performed as assessed by the investigator;
• Absence of parenchymal hematoma on CT images performed in the angio suite.
• Within 24 hours from symptom onset;
• Signed informed consent by patient or patient's legally authorized representative.

Exclusion criteria

• Patients with completed infarction in the territory of the MeVO on non-contrast CT;
• Patients with intracranial hemorrhage;
• Coagulation disorders, tendency for systemic hemorrhagic, thrombocytopenia (<100,000/mm3);
• Severe hepatic or renal dysfunction, increase in ALT or AST (more than 2 times of upper limit of normal value), increase in serum creatinine (more than 1.5 times of upper limit of normal value) or requiring dialysis;
• After mechanical thrombectomy, severe and sustained (> 5 minutes) uncontrolled hypertension (systolic blood pressure over 180mmHg or diastolic blood pressure over 105 mmHg);
• Patients with contraindication or allergy to any ingredient of study medication;
• Pregnancy, plan to get pregnant or active lactation;
• The estimated life expectancy is less than 6 months due to other serious diseases;
• Other conditions unsuitable for this clinical study as assessed by researcher.