Teneteplase Reperfusion Therapy in Acute Ischemic Cerebrovascular Events-Ⅳ(TRACE Ⅳ)

Inclusion Criteria

1. Age ≥ 18 years;

2. Can be treated with study drug within 12 hours of symptoms onset*(*Symptom onset is defined by the "last seen normal" principle);

3. Clinical diagnosis of minor ischemic stroke (baseline NIHSS≤5) with a measurable neurological deficit defined as impairment of language or motor function;

4. DWI/FLAIR mismatch on magnetic resonance imaging.

5. Pre-stroke mRS 0-1;

6. Informed consent signed.

Exclusion Criteria

1. Contradictory or unable to complete MRI examination.

2. Planned or likely acute endovascular treatments (any angioplasty or vascular surgery);

3. NIHSS 1a > 2;

4. Known allergic to rhTNK-tPA;

5. Known history of intracranial hemorrhage;

6. Clinical stroke or serious head/spinal trauma within 3 months;

7. Intracranial or spinal surgery within 3 months;

8. Known history of gastrointestinal or urinary tract hemorrhage in the previous 21 days.

9. Participants with a history of major surgery in the previous 14 days;

10. Arterial puncture at a non-compressible site in the previous 7 days.

11. Participants with intracranial tumors (excluding neuroectoderm origin, such as meningioma), huge intracranial aneurysm, or arterio-venous malformation.

12. Intracranial hemorrhage (including cerebral parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural/epidural hematoma)

13. Participants with active visceral bleeding;

14. Participants with aortic arch dissection;

15. Participants with a known bleeding diathesis or with a platelet count < 100×109/L;

16. Participants with a systolic blood pressure > 180 or a diastolic blood pressure > 100 mmHg after repeated measurements and aggressive treatments;

17. Blood glucose < 2.8 or > 22.2 mmol / L);

18. Clear indication for anticoagulation (presumed cardiac source of embolus, e.g., atrial fibrillation, prosthetic cardiac valves known or suspected endocarditis);

19. Receive intravenous thrombolysis within 24 hours;

20. Receive direct oral anticoagulant therapy with international normalized ratio (INR) > 1.7s or PT > 15 s;

21. Receive low molecular weight heparin or heparinoid within 24 hours;

22. Receive thrombin inhibitors or factor Xa inhibitors within 48 hours;

23. Receive GP2b3a inhibitors within 72 hours;

24. Participants who have large areas (greater than one third of middle cerebral artery territory) of obvious low density on the baseline CT scan;

25. Participants with a seizure at onset thought to be presenting with postictal paralysis (Todd's paralysis) mimicking stroke.

26. Participants with severe infection, such as bacterial endocarditis, pericarditis, acute pancreatitis;

27. Pregnant, currently trying to become pregnant, or of child-bearing potential and not using birth control;

28. Participation in another clinical study with an experimental product in the previous 3 months;

29. Participants deemed unsuitable for participation in this trial by the investigator or those for whom participation in this trial may result in greater risks.