Minocycline After Successful Endovascular Thrombectomy Recanalization in Posterior Circulation Arterial Occlusion (ATTRACTION-MINOP)

Inclusion Criteria: 1. Age ≥18 years; 2. Pre-stroke mRS score of 0-1; 3. Time from symptom onset to randomization ≤24 hours, including wake-up stroke or unwitnessed stroke. Symptom onset is defined as the last known well time; 4. Baseline NIHSS score ≥6;; 5. Posterior Circulation ASPECTS ≥6 on non-contrast CT or DWI; 6. Clinical symptoms attributable to acute occlusion of the intracranial vertebral artery or basilar artery, confirmed by CTA, MRA, or DSA; 7. Successful recanalization defined as mTICI 2b-3 after mechanical thrombectomy, with no evidence of secondary embolization in non-target vessels; or spontaneous improvement to mTICI 2b-3 on diagnostic angiography prior to thrombectomy with no planned intervention; 8. Ability of the patient or legally authorized representative to provide written informed consent. Exclusion Criteria: 1. Acute intracranial hemorrhage on CT or MRI; 2. Occlusion involving both anterior and posterior circulations on CTA, MRA, or DSA (except in patients with a prior history of anterior circulation occlusion); 3. Complete bilateral thalamic infarction or bilateral brainstem infarction on CT or MRI; 4. Cerebellar infarction with significant mass effect or compression of the fourth ventricle on CT or MRI; 5. Vascular anatomy on CTA, MRA, or DSA that is severely tortuous, demonstrates significant anatomical variation, or shows severe stenosis or dissection precluding navigation of thrombectomy devices to the target vessel; 6. History of pseudomembranous colitis or antibiotic-associated colitis; 7. Known allergy to tetracycline antibiotics, any component of the investigational drug, radiocontrast agents, or nitinol materials; 8. Known resistance to tetracycline antibiotics; 9. Use of tetracycline antibiotics within 7 days prior to randomization; 10. History of intracranial hemorrhage within the past 3 months, including intraparenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage, subdural hematoma, or epidural hematoma; 11. Intracranial tumors, vascular malformations, or other space-occupying intracranial lesions; 12. History of intracranial or spinal surgery within the past 3 months; 13. History of major surgery or significant trauma within the past 1 month; 14. Receipt of any of the following treatments within the past 3 months: systemic retinoic acid or androgen/antiandrogen therapy (e.g., anabolic steroids, spironolactone); 15. Platelet count \<100 × 10⁹/L; 16. Severe hepatic insufficiency, chronic hemodialysis, or severe renal insufficiency (defined as estimated glomerular filtration rate \<30 mL/min or serum creatinine \>265.2 μmol/L \[3.0 mg/dL\]); 17. Women who are pregnant or lactating, or who have a positive pregnancy test prior to randomization; 18. Life expectancy \<6 months (e.g., due to malignancy or severe cardiopulmonary disease); 19. Participation in another interventional clinical trial that may affect outcome assessment; 20. Any other condition that, in the investigator's judgment, makes the patient unsuitable for participation or poses significant risk (e.g., inability to understand or comply with study procedures or follow-up due to psychiatric, cognitive, or emotional disorders).