Clinical Research Directory

Inclusion Criteria: 1. Age ≥18 years old; 2. Acute ischemic stroke treated with intravenous thrombolysis with alteplase or tenecteplase within 4.5 hours of onset or time last known well and can receive the study drug treatment within 3 hours of initiating intravenous thrombolysis. 3. Residual NIHSS score ≥ 5 points at randomization (at least 1 hour after intravenous thrombolytic therapy). 4. Post-thrombolysis imaging shows that the offending artery is consistent with moderate or severe intracranial atherosclerotic stenosis (within 50%\~99%) 5. Informed consent obtained from patients or their acceptable surrogates. Exclusion Criteria: 1. Intracranial hemorrhage confirmed by imaging post-thrombolysis. 2. Stroke caused by other determined causes, including moyamoya disease, artery dissection, arteritis, etc. 3. Scheduled for or received endovascular treatment after onset. 4. Definite or suspected cardioembolic stroke. 5. Definite anticipation of developing indications for anticoagulant therapy during the study period (e.g., atrial fibrillation, mechanical heart valve, deep vein thrombosis, pulmonary embolism, antiphospholipid syndrome, hypercoagulable state). 6. Use of antiplatelet or anticoagulant therapy within one week pre-stroke. 7. Pre-stroke mRS score ≥ 2. 8. Severe consciousness disturbance with NIHSS item 1a (level of consciousness) \>1 point at randomization. 9. History of tirofiban allergy or its solvents. 10. History of platelet count \< 100 × 109/L caused by tirofiban. 11. Major surgical operation within 6 weeks. 12. Major systemic hemorrhage within 30 days; 13. Determined coagulation disorders, platelet dysfunction, or platelet count \< 100\*109/L. 14. Currently pregnant or lactating; 15. Uncontrolled hypertension with systolic blood pressure \> 180 mmHg or diastolic blood pressure \> 110 mmHg. 16. Acute pericarditis or hemorrhagic retinopathy. 17. Presence of malignant tumors, chronic hemodialysis, severe renal insufficiency (GFR \< 30 ml/min or serum Cr \> 220 μmol/L (2.5 mg/dl)), severe hepatic insufficiency (serum ALT \> 2 times the upper limit of normal, or serum AST \> 2 times the upper limit of normal), severe heart failure (NYHA class III or IV). 18. Severe non-cardiovascular complications with an expected survival of less than 6 months. 19. Unavailability for follow-up. 20. Presence of dementia, psychiatric disorders, or other known neurological conditions that complicate follow-up. 21. Participated in this study in the past. 22. Current participation in another therapeutic study with ongoing treatment and follow-up. 23. Other conditions that are not suitable for participation in this study as determined by the investigator.