Combined Recanalization Therapy for Acute Large Vessel Occlusion Stroke

Inclusion Criteria: 1. Age: 18-75. 2. According to the current guidelines, there is a MT indication. 3. Before stroke, mRS ≤2; 4. ASPECTS ≥6; 5. MCA occlusion, with or without ICA occlusion; 6. MT unsuccessful, TICI score 0-1; 7. Time from onset to craniotomy expected to be 24 hours or less; 8. Post-awakening stroke with mismatch between the infarct zone and the penumbra zone; Exclusion Criteria: 1. Comorbid hemorrhagic vascular disease such as intracranial aneurysm or vascular malformation or other planned cerebrovascular surgery that may alter cerebral hemodynamics or lead to stroke; 2. unstable angina or myocardial infarction, congestive heart failure within the previous 6 months; 3. Pregnancy or perinatal period; 4. Hematologic disorders resulting in coagulation disorders; 5. Combination of other diseases with a life expectancy of less than 2 years; and 6. previous treatment with intracranial or extracranial vascular bypass surgery; 7. allergy to iodine or X-ray contrast media, creatinine \>3.0 mg/dl or other contraindications to arteriography; 8. Uncontrolled diabetes mellitus, fasting blood sugar (FBS) \>16.7 mmol/L; 9. Uncontrolled hypertension with sitting systolic blood pressure \>180 mmHg or sitting diastolic blood pressure \>110 mmHg; 10. Severe hepatic dysfunction, defined as serum alanine aminotransferase (ALT) and/or alanine aminotransferase (AST) \>3 times the upper limit of normal; 11. Platelets \<100×109 /L. 12. Received a clinical trial drug or device within 30 days prior to screening, or is participating in another clinical trial; 13. contraindication to general anesthesia or craniotomy; 14. other diseases or medical history that, in the investigator's judgment, may affect the efficacy or safety evaluation of this study.