Clinical Research Directory

Inclusion Criteria: 1. age ≥18 years; 2. Clinical diagnosis of acute ischemic stroke with internal carotid artery occlusion confirmed by imaging (CTA/MRA/DSA), including isolated intracranial internal carotid artery (I-type), internal carotid artery intracranial segment involving middle cerebral artery (L-type), or internal carotid artery intracranial segment involving middle and anterior cerebral arteries (T-type) (including tandem embolic occlusions of the internal carotid artery C1 or common carotid artery); 3. Baseline NIHSS≥6, and meeting local guidelines for mechanical thrombectomy; 4. Time from onset or last known normal to randomization within 24 hours and proceeding to mechanical thrombectomy; 5. Signed informed consent (or by legal representative). Exclusion Criteria: 1. Pre-stroke mRS score \>2 2. Intracranial hemorrhage shown on imaging; 3. Known or suspected internal carotid artery occlusion caused by dissection or atherosclerosis; 4. Vascular tortuosity preventing the use of balloon guide catheter; 5. Prior stent implantation in the target vessel that would impede the use or removal of mechanical thrombectomy devices; 6. Any other circumstances impeding mechanical thrombectomy implementation; 7. Acute occlusion of multiple vascular territories in bilateral anterior circulation or in both the anterior and posterior circulations confirmed by CTA/MRA; 8. Pregnant subjects; 9. Subjects allergic to contrast agents; 10. Subjects refusing to cooperate or unable to tolerate interventional procedures; 11. Subjects whose expected lifetime are less than 90 days; 12. Midline shift or herniation with ventricular mass effect; 13. Subjects deemed unable to participate in follow-up by investigators; 14. Other situations deemed unsuitable for balloon guide catheter use by investigators.