This study will compare two ways of treatment for acute ischemic stroke: an endovascular treatment (EVT), defined as intraarterial thrombolysis and/or mechanical thrombectomy as a first choice treatment versus intravenous thrombolytic therapy (IVT) only or followed by EVT in patients with acute ischemic stroke due to a main brain artery occlusion within 4.5 hours after onset. Patients treated with IVT only or with IVT followed by EVT will be analyzed separately.

Inclusion Criteria:

• 80 or less years old patients with acute stroke produced by a main artery occlusion
• NIHSS National Institutes of Health Stroke Scale score greater than 6 (severe neurological impairment)
• Patients receiving EVT or IVT within 4.5 hours after onset

Exclusion Criteria:

• EVT or IVT contraindication
• Previous neurological impairment, severe concomitant disease or poor prognosis.
• Pregnancy or breastfeeding
• Known hypersensitivity to any study drugs
• Severe organic disease for which there is not risk compensation.

Patients younger than 80 with acute ischemic stroke produced by a main artery oclussion with a NIHSS > 6 (National Institute of Health Stroke Scale) receiving IVT or EVT within 4.5 hours after onset.