PCSK9 Inhibitors in Acute Ischemic Stroke Patients Undergoing Endovascular Therapy

Inclusion Criteria: * Age ≥ 18 years. * Meets the diagnostic criteria for acute ischemic stroke according to the Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke 2023. * Severe stenosis or occlusion of large anterior circulation vessels confirmed by DSA, MRA, or CTA. * Preoperative NIHSS score ≥ 4 and \< 25. * Meets the indications for endovascular therapy per the Chinese Guidelines for Endovascular Therapy of Acute Ischemic Stroke 2023, and successful reperfusion of the target vessel (mTICI ≥ 2b) achieved via emergency endovascular intervention. * LDL-C \> 1.8 mmol/L or non-HDL cholesterol \> 2.6 mmol/L. * Signed informed consent provided by the patient or their legally authorized representative. Exclusion Criteria: * Confirmed non-atherosclerotic causes of vascular stenosis/occlusion (e.g., cardioembolism, vasculitis, vascular malformation, moyamoya disease, iatrogenic causes). * History of intracranial hemorrhage or systemic bleeding within the past 3 months. * Presence of hemorrhagic transformation (PH1/PH2) immediately after the procedure. * Severe hepatic impairment: ALT \> 3 times the upper limit of normal, INR \> 1.2, hepatic encephalopathy, or history of drug-induced liver injury. * Use of PCSK9 inhibitors within 6 months prior to enrollment. * Pre-stroke mRS ≥ 2. * Terminal illness (e.g., malignancy, end-stage renal disease) with an expected survival of \< 3 months. * Pregnancy or lactation. * Other neurological diseases that may interfere with neurological function assessment during follow-up. * Allergy or intolerance to PCSK9 inhibitors or statins. * Participation in another interventional clinical trial.