A Trial of Adacolumn on Cerebral Edema After Anterior Circulation Ischemic Stroke

Inclusion Criteria: 1. Age 18-80 years, regardless of gender; 2. A clinical diagnosis of acute ischemic stroke; 3. Proven large vessel occlusion in ICA or MCA-M1 occlusion (carotid occlusions can be cervical or intracranial, with or without tandem MCA lesions) determined by MRA or CTA or DSA; 4. NIHSS score ≥10 at screening; 5. Pre-stroke mRS score \<2 (independent in all activities of daily living); 6. Time from stroke onset to initiation of the first Adacolumn treatment is ≤10 hours, stroke onset is defined as the last time the patient was known to be at their neurological baseline (wake-up strokes qualify if within this time window); 7. All endovascular thrombectomy procedures must strictly adhere to the "2024 Chinese Stroke Association Guidelines for Reperfusion Therapy in Acute Ischemic Stroke" and the latest prescribing information/instructions for use regarding indications, contraindications, and procedural standards; 8. Written informed consent obtained from the patient or legally authorized representative. Exclusion Criteria: 1. Decompressive craniectomy performed before enrollment or between enrollment and initiation of study treatment; 2. Patients who receive intravenous thrombolysis (including bridging therapy) for the index ischemic stroke episode before or during endovascular thrombectomy; or undergo permanent intracranial or extracranial stent implantation (including intracranial stent-assisted thrombectomy or carotid stenting) during the index endovascular procedure; 3. After endovascular thrombectomy: extensive contrast extravasation (diffuse subarachnoid high density or parenchymal high density not consistent with hematoma), new subarachnoid hemorrhage（SAH）, or symptomatic intracranial hemorrhage (sICH); 4. Large-vessel occlusion is attributed to other determined etiologies per TOAST classification, such as tumor-related, dissection-related, or other clearly identifiable non-LAA/non-CE causes. 5. Clinical signs of brain herniation, such as unilateral or bilateral fixed dilated pupils and/or other loss of brainstem reflexes attributable to cerebral edema or herniation in the investigator's opinion; 6. Intracranial lesions conferring markedly increased bleeding risk (known brain tumor, arteriovenous malformation, aneurysm); 7. Inability to undergo MRI; 8. Absolute neutrophil count \<1.5×10⁹/L or \>15×10⁹/L 9. Absolute monocyte count \> 1.0 ×10⁹/L; 10. Red blood cells \<3.0×10¹²/L ; 11. Active internal bleeding or bleeding tendency (such as platelet count \<100×10⁹/L, INR \>1.7, PT \>15 seconds); 12. Marked hypercoagulability (fibrinogen \>700 mg/dL); 13. Intracranial or spinal surgery or severe head trauma within the past 3 months; 14. Refractory hypertension (persistent systolic blood pressure \>185 mmHg or diastolic \>110 mmHg); 15. Known allergy to components of the blood purification system (including adsorption membrane, anticoagulants); 16. Acute ST-segment elevation myocardial infarction and/or acute decompensated heart failure and/or corrected QT interval \>520 ms and/or history of cardiac arrest within the past 6 months(pulseless electrical activity, ventricular tachycardia, ventricular fibrillation, or asystole); 17. Body temperature \>38°C or active infection; 18. Active autoimmune disease or immunodeficiency; 19. Participation in another interventional clinical trial within the past 30 days; 20. Any other condition deemed unsuitable for participation by the investigator.