A Randomized Trial of the Rapamycin Target Eluting Stent for the Treatment of Symptomatic Cerebral Artery Atherosclerotic Disease（TARGET-DREAM）

Inclusion Criteria: * 1\) Age 18-80 years old * 2\) Symptomatic cerebral artery atherosclerotic stenosis (defined as ischemic stroke or TIA due to qualifying lesion stenosis occurring in the past 6 months) with ineffective antiplatelet therapy or hypoperfusion in the territory of qualifying artery or with poor collateral circulation * 3\) Lesion located in a major cerebral artery, including the internal carotid artery, middle cerebral artery, vertebral artery, or basilar artery * 4\) 70%-99% stenosis of qualifying lesion according to WASID method diagnosed by DSA * 5\) Subject with at least one or more risk factors, including hypertension, diabetes mellitus, hyperlipidemia, hyperhomocysteinemia, coronary artery disease, obesity, smoking history, etc * 6\) Subject and/or their legal representatives have the necessary mental capacity to understand the study purpose, agree to participate in the study, and sign the informed consent form Exclusion Criteria: * 1\) mRS score≥3 * 2\) Last ischemic stroke onset within 2 weeks * 3\) Presence of 2 or more atherosclerotic stenotic lesions in the cerebral arteries requiring interventional or surgical treatment. * 4\) Only perforator infarctions in the territory of qualifying artery according to preoperative imaging * 5\) Hemorrhagic transformation in the territory of qualifying artery. Any parenchymal, subarachnoid, subdural, or extradural hemorrhage within 30 days prior to procedure, or untreated chronic subdural hematoma(≥5 mm) according to preoperative imaging * 6\) Restenosis of qualifying lesion due to previous stenting. * 7\) Qualifying lesion with severe calcification, extreme eccentricity, or extreme angulation which may affect stent deployment * 8\) Stenosis caused by non-atherosclerotic lesions, such as arterial dissection, moya-moya disease, or vasculitis * 9\) Concomitant severe stenosis (≥70% stenosis as measured by the WASID method) in the distal or proximal to qualifying lesion * 10\) Concomitant multiple stenoses where qualifying lesions cannot be identified * 11\) Thrombus in the qualifying artery or complete occlusion of the qualifying artery * 12\) Severe calcification or tortuosity of qualifying artery to prevent stent from successful positioning and dilatation * 13\) Stenting in qualifying artery within one year * 14\) Concomitant aneurysms requiring treatment * 15\) Concomitant intracranial malignant tumors, intracranial arteriovenous malformations, intracranial venous sinus thrombosis, or other conditions inappropriate to participate in the study * 16\) Resistant hypertension (systolic pressure ≥180 mmHg or diastolic pressure ≥110 mmHg) despite use of medication * 17\) Acute myocardial infarction within 4 weeks prior to enrollment, or suspected cardiogenic embolism * 18\) Subjects with severe systemic diseases that cannot tolerate surgery, such as severe hepatic or renal impairment * 19\) Severe cognitive impairment or mental diseases * 20\) Contraindications to anticoagulants or antiplatelet drugs, such as anticoagulant or antiplatelet drug allergy, active bleeding, or coagulation disorder * 21\) Subjects with allergy or suspected allergy to anesthetics, contrast agents, rapamycin, polylactic acid, nickel-titanium alloy, cobalt-chromium alloy, stainless steel, and other stent materials, medications, and intraoperative medications * 22\) Women who are pregnant or breastfeeding * 23\) Subjects who are participating or planning to participate in any drug or device clinical study at the time of enrollment * 24\) Life expectancy ≤ 1 year * 25\) Other conditions inapplicable to participate in the study according to investigators' judgment