Endovascular Treatment of Chronic Intracranial Artery Occlusion

Inclusion Criteria: 1. Age ≥18 years 2. Occlusion of the unilateral middle cerebral artery, basilar artery, intracranial internal carotid artery, or vertebral artery, as confirmed by computed tomography angiography (CTA), magnetic resonance angiography (MRA), or digital subtraction angiography (DSA) 3. Modified Rankin Scale (mRS) score of 0-2 4. Presence of symptoms related to the occluded vessel, as determined by the physician, with the most recent symptom onset occurring more than 4 weeks and within 6 months prior to enrolment 5. The subject or their legally authorised representative has provided written informed consent for the study Exclusion Criteria: 1. Evidence of hemorrhage on CT or MRI 2. Large hemispheric infarction involving \>50% of the middle cerebral artery territory on CT or MRI 3. Severe pre-stroke disability (modified Rankin Scale score ≥2) or life expectancy \<12 months 4. Major comorbidities that may interfere with outcome assessment and follow-up (e.g., severe heart failure, renal failure, etc.) 5. Uncontrolled seizure at the time of stroke onset 6. Baseline platelet count \<50,000/μL 7. Severe, persistent hypertension that remains uncontrolled despite active management (systolic blood pressure \>220 mmHg or diastolic blood pressure \>120 mmHg) 8. Known inherited or acquired bleeding diathesis, coagulation factor deficiency, or recent oral anticoagulant therapy with an international normalized ratio (INR) \>3 9. Suspected septic emboli or suspected bacterial endocarditis 10. Known allergy to iodine, heparin, or anaesthetics, or other definite contraindications to endovascular procedures 11. Pregnant women 12. Other severe, progressive, or terminal diseases (as judged by the investigator), or life expectancy \<24 months 13. Prior attempted endovascular recanalization therapy before randomization 14. Current participation in other studies involving investigational drugs or devices 15. Evidence of intracranial tumour on CT or MRI (except meningioma) 16. Excessive tortuosity of cervical vessels on CTA/MRA that may preclude endovascular therapy