Hemoadsorption for Severe Ischemic Stroke

1.18 years ≤ age \< 80 years; 2.Pre-stroke mRS score ≤ 1; 3.Anterior circulation cerebral infarction within 48 hours of onset, meeting at least one of the following:

1. 15≤ NIHSS score ≤32;
2. 3\<GCS score ≤12;
3. CT hypodensity area >1/2 of the MCA territory; 4.hs-CRP ≥2 mg/L at randomization; 5.If reperfusion therapy is performed, no improvement in NIHSS score (still ≤32) post-treatment; 6.Signed informed consent obtained.

Exclusion Criteria:

1. Hemorrhagic transformation of PH2 type prior to randomization;
2. Brain herniation or decompressive craniectomy performed before randomization;
3. Hemodynamic instability refractory to medical correction (systolic blood pressure \<70 mmHg or diastolic blood pressure \<50 mmHg) or decompensated heart failure (NYHA Class III or IV);
4. Severe hepatic impairment (defined as ALT >2 times the upper limit of normal or AST >2 times the upper limit of normal) and renal impairment (defined as serum creatinine >1.5 times the upper limit of normal or estimated glomerular filtration rate [eGFR] \<50 mL/min);
5. Coagulopathy or thrombocytopenia (platelet count \<100×10⁹/L);
6. Deep vein thrombosis (DVT) of the lower extremities before randomization;
7. Life expectancy \<90 days due to malignancy;
8. Participation in another drug or device clinical trial within the past 30 days or ongoing enrollment in such trials;
9. Women of childbearing potential with a negative pregnancy test who refuse to use effective contraception, or pregnant/lactating women;
10. Absolute contraindications to hemoadsorption therapy.