stroke is a leading cause of morbidity and mortality worldwide. More than half (54.5%) of the 56.9 million deaths worldwide in 2106 were due to the top 10 causes.

Ischemic heart disease and stroke are the world's biggest killers, accounting for a combined 15.2 million deaths in 2106. These diseases have remained the leading causes of death globally in the last 15 years.

Recent clinical trials have shown that endo-vascular thrombectomy is an effective and safe recanalization modality for acute ischemic stroke patients .

Meta-analysis results show that endovascular treatment is associated with a high ratio of successful recanalization rate and a low rate of symptomatic hemorrhage .

Approximately 2.2-37.5% of patients with acute ischemic stroke might encounter early neurological deterioration (END).

Definition of END: An increase in NIHSS ≥4 or an increase in Ia of NIHSS ≥1 within 72 h after recanalization treatment.

Inclusion Criteria:

1. Ischemic stroke of both sex.
2. More than 08 years.
3. Accepting all study requirements.
4. within time window for thrombolysis or thrombectomy
5. fulfilling criteria for thrombolysis or thrombectomy

Exclusion Criteria:

(A)Absolute Contraindications :

1. Intracerebral hemorrhage history or presence on imaging
2. Time of onset more than 465 hours
3. Blood pressure greater than 085/000 mm Hg
4. Recent severe head trauma or neurosurgical intervention
5. Coagulopathy (INR >067, thrombocytopenia, recent use of heparin or direct oral anticoagulants)
6. Endocarditis (infective)
7. Aortic dissection (B)Potential Contraindications :

1.Seizure at onset 2.Noncompressible arterial puncture 3.Recent surgery 4.Gastrointestinal or genitourinary bleeding 5.Multiple cortical microbleeds (>00) 6. Large intracranial aneurysms or arteriovenous malformations 7.Recent transmural myocardial infarction 8. Small NIHSS with nondisabling stroke symptoms

All patients admittedto Assiut University Hospitals within time window for thrombolysis or thrombectomy within one year are included