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RecruitingNCT07185022RESCUE MeVOUpdated Apr 16, 2026

Intra-arterial Thrombolysis for Acute Ischemic Stroke With Medium Vessel Occlusion

An interventional study of Intra-arterial Thrombolysis and Best Medical Treatment in Stroke, Cerebrovascular Disorders and Brain Diseases, sponsored by The Second Hospital of Anhui Medical University. Recruiting at 6 sites in China. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-16.

Primary conditionIschemic StrokeRegistry: StrokeReclassifiedWhy we changed it
Registry
Stroke — the first condition term the registry derived for this study.
ClinicalTrials.gg
Ischemic Stroke
Why
  1. The study's listed conditions name Ischemic Stroke, a narrower term within Stroke.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by The Second Hospital of Anhui Medical University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Jan 2026; still recruiting 10 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
282
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Acute ischemic stroke (AIS) due to medium vessel occlusion (MeVO) or severe stenosis poses a significant clinical challenge. Recent large randomized controlled trials, DISTAL and ESCAPE-MeVO, demonstrated no significant benefit of endovascular therapy in patients with MeVO. Although intra-arterial thrombolysis has shown promise in clinical experience, robust evidence supporting its efficacy in MeVO or severe stenosis-related AIS is still absent. To fill this gap, the RESCUE MeVO trial has been designed as a multicenter, prospective, randomized, open-label, blinded end-point (PROBE) study to evaluate the efficacy and safety of intra-arterial thrombolysis in patients with AIS caused by MeVO or severe stenosis.

Read the detailed description

This study is a multicenter, prospective, randomized, open-label, blinded end-point (PROBE) trial. Eligible participants will be adults (age >18 years) presenting with acute ischemic stroke (AIS) due to MeVO or severe stenosis (≥70%). Participants who meet all inclusion criteria and none of the exclusion criteria will be randomly assigned in a 1:1 ratio to one of two treatment arms. The control group will receive best medical management alone, while the intervention group will receive best medical management in combination with intra-arterial thrombolysis. Intra-arterial thrombolysis is performed by infusing rhTNK-tPA (Tenecteplase) proximal to the occlusion or severe stenosis for 5-30 minutes, with the decision to continue beyond the first 5 minutes being guided by intraprocedural DSA. The primary objective of this study is to evaluate the efficacy and safety of intra-arterial thrombolysis in patients with acute ischemic stroke caused by MeVO or severe stenosis. The primary endpoint is excellent outcome at 90 days, defined as a score of 0-1 on the modified Rankin Scale (mRS).

02

Conditions studied

  • Stroke
  • Cerebrovascular Disorders
  • Brain Diseases
  • Nervous System Diseases
  • Vascular Diseases
  • Ischemic Stroke
  • Infarction
  • Medium Vessel Occlusion

Keywords

  • Ischemic stroke
  • Medium vessel occlusion
  • Stroke
  • Intra-arterial thrombolysis
  • Severe stenosis
03

In context

Ischemic Stroke Reclassified

2,612 studies on the registry are indexed under Ischemic Stroke; 971 are open to participants now.

This study's planned enrollment of 282 is above the median of 120 across 1,776 interventional studies indexed under Ischemic Stroke.

Browse Ischemic Stroke studies →

Lead sponsor

The Second Hospital of Anhui Medical University is the lead sponsor of 30 studies on the registry; 18 are open to participants now.

Compared within Ischemic Stroke, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Stroke. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age > 18 years
  • Primary medium vessel occlusion (MeVO) or severe stenosis (≥70%) was detected on CTA, MRA, or DSA, involving arterial segments including M2-M3 of the middle cerebral artery (MCA), A1-A2 of the anterior cerebral artery (ACA), P1-P2 of the posterior cerebral artery (PCA), and the anterior inferior cerebellar artery (AICA), posterior inferior cerebellar artery (PICA), and superior cerebellar artery (SCA)
  • The clinical symptoms were consistent with MeVO, with a NIHSS score 5 - 25, or an NIHSS score of 3-4 in the presence of disabling neurological deficits (e.g., hemianopia, aphasia, or motor dysfunction)
  • Intra-arterial thrombolysis was administered within the following time windows:

    1. Acute ischemic stroke within 24 hours of symptom onset or last known well, including stroke with known onset, wake-up stroke and stroke with unknown onset, with no obvious hypodensity on CT and good collateral circulation on CTA;
    2. Acute ischemic stroke within 24-72 hours of onset, meeting at least one of the following imaging criteria: a.CT or MR perfusion imaging demonstrating target mismatch, defined as an ischemic core volume \<30 mL, a mismatch ratio ≥1.2, and a mismatch volume ≥10 mL.; b.MRI demonstrating DWI-FLAIR mismatch, defined as the presence of acute ischemic lesions on diffusion-weighted imaging (DWI) with no corresponding hyperintense signal on FLAIR, or with FLAIR hyperintense lesions occupying less than one-third of the DWI lesion volume.
  • Signed obtained

Exclusion criteria

Exclusion Criteria:

  • Pre-stroke mRS ≥ 2
  • Secondary MeVO or severe stenosis caused by endovascular therapy
  • Neuroimaging demonstrated intracranial hemorrhage, subarachnoid hemorrhage, or other hemorrhagic disorders
  • Non-contrast CT demonstrating a clearly hypodense lesion corresponding to the vascular territory
  • count \<100 × 10⁹/L, known bleeding tendency or coagulation factor deficiency, or oral anticoagulant therapy with an (INR) >3.0
  • Persistent and uncontrolled hypertension, defined as systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg
  • History of intracranial hemorrhage within the past 3 months, including parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, epidural hemorrhage, or subdural hemorrhage
  • Presence of arteriovenous malformations or brain tumors with mass effect
  • Gastrointestinal or urinary tract bleeding, or major surgery within the past 3 months
  • Chronic dialysis or severe renal impairment, defined as a (GFR) \<30 mL/min or serum creatinine >220 μmol/L (2.5 mg/dL)
  • Patients with known allergy to thrombolytic agents or their
  • Patients with known allergy to iodinated contrast agents or other established
  • Pregnant or current breastfeeding
  • Presence of severe systemic comorbidities with a of less than 3 months
  • Deemed unsuitable for participation by the investigator for any reason
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
282 participants (estimated)

Study arms

  • Experimental
    Intra-arterial Thrombolysis plus Best Medical Treatment

    Patients in this group will receive intra-arterial thrombolysis plus best medical treatment.

    Procedure: Intra-arterial Thrombolysis · Drug: Best Medical Treatment

  • Other
    Best Medical Treatment

    Patients in this group will receive standard medical therapy in accordance with the guideline-directed management for acute ischemic stroke.

    Drug: Best Medical Treatment

Interventions

  • ProcedureIntra-arterial Thrombolysis

    rhTNK-tPA(Tenecteplase)dose: 0.4 - 1.2mg/min, maximum dose: 16mg. Patients who have not received IVT are recommended to initiate intra-arterial administration at a rate of 0.8 mg/min, whereas those who have received IVT are recommended to receive 0.4 mg/min. The infusion rate may be dynamically adjusted by the operator according to intra-procedural circumstances, with a maximum rate not exceeding 1.2 mg/min.

  • DrugBest Medical Treatment

    Patients in this group will receive standard medical therapy in accordance with the guideline-directed management for acute ischemic stroke.

06

What researchers measure

Primary outcomes

  1. Excellent outcome

    Number of participants achieving an excellent outcome, defined as a modified Rankin Scale (mRS) score of 0-1 at 90 ± 7 days follow-up. The mRS is a widely used 7-point scale for assessing disability and functional outcomes after stroke, where higher scores represent worse outcomes.

    Time frame: Time Frame: 90 ± 7 days

Secondary outcomes

  1. Ordinal distribution of mRS

    Ordinal distribution of the modified Rankin Scale (mRS) at 90 ± 7 days. The mRS is a widely used 7-point scale for assessing disability and functional outcomes after stroke, where higher scores represent worse outcomes.

    Time frame: 90 ± 7 days

  2. Functional independence

    The proportion of patients achieving functional independence, defined as a modified Rankin Scale (mRS) score of 0-2 at 90 ± 7 days follow-up. The mRS is a widely used 7-point scale for assessing disability and functional outcomes after stroke, where higher scores represent worse outcomes.

    Time frame: Frame: 90 ± 7 days

  3. Poor functional outcome

    Number of participants achieving a poor functional outcome, defined as a modified Rankin Scale (mRS) score of 4-6 at 90 ± 7 days follow-up. The mRS is a widely used 7-point scale for assessing disability and functional outcomes after stroke, where higher scores represent worse outcomes.

    Time frame: 90 ± 7 days

  4. Early neurological deterioration

    The proportion of patients with an increase of ≥ 4 points in the National Institutes of Health Stroke Scale (NIHSS) score, within 24 ± 12 hours post-randomization. The NIHSS is a standardized 11-item assessment tool designed to quantify neurological deficits in patients with acute stroke. The total score ranges from 0 to 42, with higher values indicating more severe deficits.

    Time frame: 24 ± 12 hours

  5. Any neurological improvement

    The proportion of patients with a reduction of ≥ 2 points in the National Institutes of Health Stroke Scale (NIHSS) score from baseline at 24 ± 12 hours post-randomization. The NIHSS is a standardized 11-item assessment tool designed to quantify neurological deficits in patients with acute stroke. The total score ranges from 0 to 42, with higher values indicating more severe deficits.

    Time frame: 24 ± 12 hours

  6. Early neurological improvement

    The proportion of patients with a reduction of ≥ 4 points in the National Institutes of Health Stroke Scale (NIHSS) score from baseline at 24 ± 12 hours post-randomization. The NIHSS is a standardized 11-item assessment tool designed to quantify neurological deficits in patients with acute stroke. The total score ranges from 0 to 42, with higher values indicating more severe deficits.

    Time frame: 24 ± 12 hours

Other outcomes

  1. Symptomatic intracranial hemorrhage

    The incidence of symptomatic intracranial hemorrhage within 24 ± 12 hours post-randomization

    Time frame: 24 ± 12 hours

  2. All cause mortality

    All cause mortality at 90 ± 7 days.

    Time frame: 90 ± 7 days

07

Study locations

6 of 6 sites recruiting
  • Fu Yang People's Hospital
    Fuyang, Anhui, China
    Recruiting
    • Juluo Chen · Contact0558-3010999
    • Juluo Chen · Principal investigator
  • Lin Quan People's Hospital
    Fuyang, Anhui, China
    Recruiting
    • Susheng Long · Contact0558-6403761
    • Susheng Long · Principal investigator
  • The Second (Affiliated) Hospital of Anhui Medical University
    Hefei, Anhui 230031, China
    Recruiting
    • Qi Li, professor · Contactqili_md@126.com · +8618623511778
    • Qi Li, professor · Principal investigator
  • Shucheng People's Hospital
    Lu'an, Anhui, China
    Recruiting
    • Jianshang Wen · Contact0564-8621570
    • Jianshang Wen · Principal investigator
  • LiuZhou Worker's Hospital
    Liuzhou, Guangxi, China
    Recruiting
    • Xianfu Lu · Contact0772-3815345
    • Xianfu Lu · Principal investigator
  • Lishui Central Hospital
    Lishui, Zhejiang, China
    Recruiting
    • Xiao Peng · Contact05782285888
    • Xiao Peng · Principal investigator
08

References and documents

Individual participant data

Plan to share: Undecided

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 16, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07185022
Lead sponsor
The Second Hospital of Anhui Medical University
Responsible party
Qi Li (Professor, The Second Hospital of Anhui Medical University) — Principal investigator
First posted
Sep 22, 2025
Start date
Jan 6, 2026
Primary completion
Feb 1, 2030 (estimated)
Completion
May 1, 2030 (estimated)
Last update
Apr 16, 2026

Study contacts

Qi Li, professor
Contact
qili_md@126.com
+8618623511778
Qi Li, professor
principal investigator · The Second Hospital of Anhui Medical University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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