BackgroundDespite the success of endovascular thrombectomy (EVT) in restoring large-vessel patency in acute ischemic stroke (AIS), a substantial proportion of patients fail to achieve functional independence, largely due to ischemia-reperfusion injury (IRI) at the tissue level. Pharmacological neuroprotection has re-emerged as a potential strategy to mitigate these downstream injury cascades in the thrombectomy era; however, clinical evidence remains heterogeneous and mechanism-specific effects