HR-MRI-Directed Tirofiban Therapy for Late-Window Acute Ischemic Stroke (TIAN)
China458 participantsStarted 2026-02-01
Plain-language summary
This study aims to address the existing clinical challenges by introducing high-resolution magnetic resonance vessel wall imaging (HR-MRI), an advanced imaging technology, to achieve precise etiological classification in patients with acute ischemic stroke (AIS) beyond the time window. HR-MRI allows clear visualization of intracranial arterial wall structures and direct identification of key pathological features of the culprit vessel, including atherosclerotic plaques, vascular wall remodeling, and intracranial hemorrhage, thereby enabling reliable differentiation between intracranial atherosclerotic large artery atherosclerosis (ICAS-LAA) stroke and other etiological subtypes such as cardiogenic embolism. Based on the latest clinical demands and advances in imaging technology, this study intends to evaluate the efficacy and safety of tirofiban in patients with ICAS-LAA stroke beyond the time window under the precise guidance of HR-MRI. It is expected to provide high-level evidence-based medical evidence for this specific patient population and further optimize clinical diagnosis and treatment strategies.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Age ≥ 18 years old;
✓. Acute ischemic stroke (AIS) in the anterior intracranial circulation (internal carotid artery system) confirmed by clinical symptoms and imaging examinations;
✓. Time from symptom onset or last known normal state to randomization: \> 24 hours and ≤ 7 days;
✓. Stroke subtype confirmed as intracranial large artery atherosclerosis (ICAS) by high-resolution vessel wall imaging (HR-VWI) according to the TOAST classification, with cardiogenic embolism and other etiologies excluded;
✓. Baseline National Institutes of Health Stroke Scale (NIHSS) score of 4-20 at the time of randomization;
✓. Signed informed consent form obtained from the patient or their legal representative.
Exclusion criteria
✕. Planned to receive reperfusion therapy (endovascular therapy or intravenous thrombolysis)；
✕. Intracranial hemorrhage confirmed by computed tomography (CT)；
✕
What they're measuring
1
Proportion of participants with functional independence outcome [modified Rankin Scale(mRS) score 0-1]