Clinical Research Directory

Inclusion Criteria 1. Age ≥ 18 years; 2. Onset-to-treatment time \< 4.5 h; onset time defined as "last known well" time; 3. Clinical diagnosis of minor ischemic stroke (NIHSS ≤ 5) with persistent unilateral limb weakness or speech symptoms, defined as a score of ≥1 on either the language item or a single limb item of the NIHSS; 4. Pre-stroke mRS 0-1; 5. Informed consent signed. Exclusion Criteria 1. Planned or likely acute endovascular treatments before randomization; 2. NIHSS 1a \> 2; 3. Known allergic to rhTNK-tPA; 4. History of intracranial hemorrhage; 5. Severe head trauma or previous stroke within 3 months； 6. Intracranial or spinal surgery within 3 months; 7. Gastrointestinal or urinary tract hemorrhage within 3 weeks； 8. Major surgery within 2 weeks; 9. Arterial puncture at a non-compressible site within 1 week； 10. Intracranial tumors (excluding neuroectodermal tumors, e.g., meningiomas), large intracranial aneurysms, or arteriovenous malformations； 11. Intracranial hemorrhage, including intraparenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, and subdural/epidural hematoma; 12. Active visceral bleeding; 13. Concomitantaortic arch dissection; 14. Acute bleeding tendency, including platelet count \<100×10⁹/L or other clinically significant conditions; 15. Uncontrolled hypertension after active antihypertensive treatment: systolic blood pressure \>180 mm Hg or diastolic \>100 mm Hg; 16. Blood glucose \< 2.8 or \> 22.2 mmol / L; 17. Prior anticoagulant therapy, such as oral warfarin, with an INR \>1.7 or PT \>15 seconds; 18. Use of heparin within 24 hours; 19. Use of thrombin inhibitors or factor Xa inhibitors within 48 hours; 20. Large cerebral infarction on head CT or MRI (infarction area \>1/3 of the middle cerebral artery territory); 21. Todd's paralysis after a seizure or other neurological/psychiatric disorders affecting cooperation; 22. Severe, uncontrolled infections (e.g., acute pericarditis, infective endocarditis, or acute pancreatitis); 23. Pregnant or breastfeeding women, or women unwilling to use effective contraception during the study period; 24. Participation in another clinical trial within 3 months prior to screening; 25. Other severe illnesses with a life expectancy of less than six months; 26. Deemed unsuitable for the study or at increased risk by the investigator's judgment.