Could a common antibiotic boost stroke recovery? new trial aims to find out

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age ≥18 years; 2. Pre-stroke mRS score of 0-1; 3. Time from symptom onset to randomization ≤24 hours, including wake-up stroke or unwitnessed stroke. Symptom onset is defined as the last known well time; 4. Baseline NIHSS score of 6-25; 5. ASPECTS ≥6 on non-contrast CT or DWI; 6. Clinical symptoms attributable to acute occlusion at one of the following sites, confirmed by CTA, MRA, or DSA: intracranial internal carotid artery, M1 segment of the middle cerebral artery, or M2 trunk of the MCA; 7. Successful recanalization defined as mTICI 2b-3 after mechanical thrombectomy, with no evidence of secondary embolization in non-target vessels; or spontaneous improvement to mTICI 2b-3 on diagnostic angiography prior to thrombectomy with no planned intervention; 8. Ability of the patient or legally authorized representative to provide written informed consent. Exclusion Criteria: 1. Acute intracranial hemorrhage on CT or MRI; 2. Bilateral acute stroke or multiple intracranial large vessel occlusions; 3. Isolated extracranial internal carotid artery occlusion; 4. History of pseudomembranous colitis or antibiotic-associated colitis; 5. Known allergy to tetracycline antibiotics, any component of the investigational drug, radiocontrast agents, or nitinol materials; 6. Known resistance to tetracycline antibiotics; 7. Use of tetracycline antibiotics within 7 days prior to randomization; 8. History of intracranial hemorrhage within the past 3 months, including intraparenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural hematoma, or epidural hematoma; 9. Intracranial tumors, vascular malformations, or other space-occupying intracranial lesions; 10. History of intracranial or spinal surgery within the past 3 months; 11. History of major surgery or significant trauma within the past 1 month; 12. Receipt of any of the following treatments within the past 3 months: systemic retinoic acid or androgen/antiandrogen therapy (e.g., anabolic steroids, spironolactone); 13. Platelet count \<100 × 10⁹/L; 14. Severe hepatic insufficiency, chronic hemodialysis, or severe renal insufficiency (defined as estimated glomerular filtration rate \<30 mL/min or serum creatinine \>265.2 μmol/L \[3.0 mg/dL\]); 15. Women who are pregnant or lactating, or who have a positive pregnancy test prior to randomization; 16. Life expectancy \<6 months (e.g., due to malignancy or severe cardiopulmonary disease); 17. Participation in another interventional clinical trial that may affect outcome assessment; 18. Any other condition that, in the investigator's judgment, makes the patient unsuitable for participation or poses significant risk (e.g., inability to understand or comply with study procedures or follow-up due to psychiatric, cognitive, or emotional disorders).