Abstract Body: Background: The impact of adjunctive intra-arterial thrombolysis administration following near-complete to complete reperfusion by endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) remains a conflict. Previously, we completed two of the largest randomized trials (the POST UK trial and the POST-TNK trial) and explored the efficacy and safety of intra-arterial thrombolysis with urokinase/tenecteplase versus no additional thrombolysis in patients with endovascular reperfusion for AIS patients due to large vessel occlusion without prior intravenous thrombolysis within 24 hours of time last known well.

Methods: We will pool individual patient data from two randomized trials (the POST-UK trial and the POST-TNK trial) that included acute ischemic stroke patients due to large vessel occlusion patients with successful endovascular reperfusion followed by intra-arterial thrombolysis (urokinase/tenecteplase) versus without additional intra-arterial thrombolysis. The primary outcome will be a modified Rankin Scale (mRS) of 0-1 at 90 days. The primary safety outcome will include mortality within 90 days and symptomatic intracranial hemorrhage within 48 hours.

Results and Conclusions: A total of 1074 eligible patients are planned to be included in this analysis, and the results will be presented at the meeting. This individual patient data meta-analysis with the currently largest sample size would provide more exact therapeutic values into the efficacy and safety of intra-arterial thrombolysis in LVO patients.