The key to the treatment of acute ischemic stroke (AIS) is the early opening of occluded vessels and restoration of blood flow to save the ischemic semidark zone tissue. However, due to the strict time window (3-4.5h) and the low recanalization rate of combined large artery occlusion (13%-18%), less than 3% of patients can benefit from this treatment, and the 90-d mortality and disability rates are as high as 21% and 68%, which is not satisfactory. In recent years, some new endovascular devices (stenting devices and thrombus aspiration devices) have been used in clinical practice, which have significantly improved the opening rate of occluded vessels, and endovascular therapy (arterial thrombolysis, endovascular thrombectomy, angioplasty stenting) has shown good prospects for application. However, in terms of target population and time window selection, optimal treatment process, and long-term benefits, there is a lack of positive clinical randomized controlled studies, and endovascular treatment with AIS will probably remain as a complementary or remedial treatment for patients with large arterial occlusions in which intravenous thrombolysis is contraindicated or ineffective for a long time. (A) Indications 1. Age 18 to 80 years. 2, Clinical diagnosis of ischemic stroke with neurological symptoms lasting more than 30 min and not resolved before treatment. 3.Onset time within 8h, posterior circulation can be extended to 24h as appropriate. Time window suitable for patients with arterial thrombolysis: within 6h of onset of anterior circulation, posterior circulation can be extended to 24h as appropriate (time of symptom onset is defined as the last normal time the patient can be confirmed). 4, CT examination to exclude intracranial hemorrhage and no early signs of large cerebral infarction imaging or hypointense shadow (anterior circulation does not exceed 1/3 of the middle cerebral artery supply area and posterior circulation does not exceed 1/3 of the brainstem volume). 5.Multi-modality or multi-temporal (or single) CT angiography/magnetic resonance angiography (CTA/MRA) examination confirms the responsible large vessel stenosis or occlusion. 6.The patient or the patient’s legal representative agrees and signs the informed consent. (B) Contraindications 1.History of hemorrhagic cerebrovascular disease, active bleeding or known bleeding tendency 2.Severe disabling stroke [modified Rankin Scale score (mRS) >3] or history of cranial or spinal surgery within 6 months. 3. Stroke with epilepsy. 4. The etiology of the vascular occlusion is initially determined to be non-atherosclerotic, such as intracranial artery entrapment. 5, Patient has a history of psychiatric or neurological disorders that may affect neurological and functional assessment. 6, Suspected septic emboli or bacterial endocarditis. 7, Survival expected <90d. 8, Known history of intracranial hemorrhage (ICH), subarachnoid hemorrhage (SAH), arteriovenous malformation (AVM), or tumor. 9, Prior known disease within the last 3 months that increases the risk of bleeding, such as severe liver disease, ulcerative gastrointestinal disease, liver failure. 10, Major surgery, significant trauma or bleeding disorders within the last 10d. 11, uncontrolled hypertension, defined as: systolic blood pressure >185 mmHg or diastolic blood pressure ≥110 mmHg confirmed by 3 repeated measurements at least 1Omin apart. 12, renal failure, defined as: serum creatinine >2.0 mg/dl (177 μmol/L) or glomerular filtration rate (GFR) <30 ml/(min?1.73m2). 13, Platelet count <100,000/mm3. 14, Blood glucose level <2.8 mmol/L or >22.2 mmol/L. 15, Patient is receiving oral anticoagulant therapy, such as warfarin, and the international normalized ratio (INR) >1.5; or has used heparin within 48h and the activated partial thromboplastin time (APTT) exceeds the upper limit of laboratory normal. 16, Clinical history combined with past imaging or clinical judgment suggesting intracranial infarction as a chronic lesion. 17, Those without femoral artery pulsation.