Could a Late-Stage clot buster help stroke patients without surgery?

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

Inclusion Criteria: * Age 18 years or greater * Acute ischemic stroke presenting in the 4.5 to 24 hour window from last seen well (including wake-up stroke and no witness stroke). * Prestroke mRS 0-2 * NIHSS 6 to 25 * Aspect ≥ 7 * ICA terminus, M1, dominant M2 occlusion on CTA or MRA * Clinical-imaging mismatch assessed by investigator * Patients with no access to EVT at the time of randomization Exclusion Criteria: * Current or past history of significant bleeding over the past 6 months; * History of intracranial hemorrhage (including possible subarachnoid hemorrhage or subarachnoid hemorrhage due to an aneurysm) or evidence or suspected intracranial hemorrhage; * Known bleeding tendency; * Recent severe or dangerous bleeding, or active ulcerative gastrointestinal disease; * History of central nervous system injury (e.g., intracranial tumor, aneurysm, or arteriovenous malformation, intracranial or spinal surgery), or recent head injury； * Tumors that increase risk of bleeding; * Severe liver dysfunction, including liver failure, cirrhosis, portal hypertension (esophageal varices), and active hepatitis; * Know arterial / venous malformation or aneurysm; * Bacterial endocarditis, pericarditis, or acute pancreatitis; * Patients receiving effective anticoagulant therapy (vitamin K antagonists with INR \> 1.3, or other oral anticoagulants exceeding the upper limit of the corresponding standard range); * Heparin use within the past 48 hours and prothrombin time exceeding the upper limit of the standard range; * Over the past 3 months, undergone major surgery, organ biopsy, or suffered a serious injury; * Over the past 2 weeks, receiving prolonged ( \>2 minutes) cardiopulmonary resuscitation, childbirth, or non-stressful vascular puncture (such as subclavian or jugular vein puncture); * Stroke episode occurred with epileptic seizure; * History of stroke comorbid with diabetes; * History of stroke over the past 3 months； * Acute bleeding tendency, including platelet count below 100×10⁹/L or other conditions; * SBP \>185 mmHg or DBP \>110 mmHg, or requiring intensive treatment (intravenous antihypertensive drugs) to lower blood pressure to within limits; * Blood glucose \<2.8 mmol/L or \>22.2 mmol/L (\<50 mg/dL or \>400 mg/dL)； * Patient life expectancy of less than 1 year; * Simultaneous occlusion of multiple blood vessels, defined as bilateral MCAs or MCAs combined with the basilar artery; * Pregnant women or nursing mothers； * Patients with a low likelihood of 3-month follow-up； * Over the past 3 months participated in other interventional clinical trials.