Intravenous Tirofiban After Bridging Therapy for Acute Stroke With Atherosclerotic Large Artery Occlusion

Inclusion Criteria: 1. Age ≥18 years old. 2. Pre-mRS 0-2. 3. Baseline NIHSS 6-30 points. 4. Baseline ASPECTS ≥6 points. 5. Baseline CTA/MRA diagnosed: the ICA or MCA-M1/M2 occlusion. 6. Receiving bridging therapy (EVT following IV Tenecteplase) within 24 hours from stroke onset. 7. Baseline DSA diagnosed: ICAD related LVO. \* ICAD-related LVO is assumed if any one the following criteria is fulfilled: (1) absence of atrial fibrillation; (2) truncal-type occlusion; (3) residual stenosis ≥30% on DSA after the first retriever; (4) researchers determined it to be ICAD-related LVO based on the TOAST classification. 8. Patients have achieved successful reperfusion after EVT (mTICI ≥2b). 9. Patients or their eligible surrogates provided informed consent. Exclusion Criteria: 1. Previously known permanent, persistent, or paroxysmal atrial fibrillation. 2. Permanent stenting during EVT; 3. Patient had severe bleeding or the following conditions, such as active gastrointestinal ulcer, aortic dissection, platelet count \<100 ×109/L, hemoglobin \<100 g/L, INR≥1.7 in the last 6 months. 4. Contraindication to glycoprotein IIb/IIIa inhibitors. 5. Imaging examination (Flat-panel NCCT/DCT) before randomization showed the following: Heidelberg hemorrhage type 1c, 2, or 3 ICH with or without clinical exacerbation (an increase of ≥4 points in the NIHSS score from baseline or an increase of ≥2 points in any of the NIHSS scores or resulting in intubation, decompression of bone valves, ventricular drainage, or other significant medical/surgical intervention), infarct area greater than 50% of the middle cerebral artery blood supply area or infarct volume ≥70ml, cerebral hernia signs. 6. Vascular malformations, arterial dissection, intracranial aneurysms, tumors (except for small meningiomas), cerebrovascular inflammation, cerebral amyloid angiopathy, or other major non-ischemic craniocerebral diseases (e.g. multiple sclerosis) as diagnosed by head imaging. 7. Acute renal failure, dialysis, or estimated glomerular filtration rate (eGFR) \< 30ml/min/1.72m2, or serum creatinine \> 220mmol/L (2.5mg/dl). 8. History of severe liver disease, or aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) and/or glutamyltransferase (GGT) ≥3×ULN and/or total bilirubin (TBIL) ≥2×ULN. 9. Acute ST elevation myocardial infarction (MI), acute decompensated heart failure, QTc\>500 ms, hospitalization or involuntary coronary intervention due to acute coronary syndrome, MI, cardiac arrest within the past 3 months. 10. Severe non-cardiovascular comorbidity with life expectancy \< 3 months (e.g., malignant tumors). 11. Any clinical conditions determined by the study team that may limit adherence to the study process. 12. Currently receiving an investigational drug or device. 13. Women of childbearing age not practicing reliable contraception who do not have a documented negative pregnancy test. 14. The subject's informed consent was not obtained.