A randomized study in acute ischemic stroke evaluates whether adding intravenous tirofiban improves outcomes for patients who do not respond adequately to intravenous tenecteplase. The trial compares IV tirofiban versus placebo given after tenecteplase in patients with acute ischemic stroke who do not have large or medium vessel occlusion or a cardioembolic cause. The research question centers on whether adjunctive treatment with tirofiban can lead to better functional results at 90 days. According to the study description, participants are those showing an inadequate clinical response to tenecteplase, meaning their initial thrombolysis is not sufficient based on the trial’s criteria. The primary outcome is functional outcome at 90 days, assessed in both treatment arms. The trial is designed to determine whether tirofiban offers benefit beyond tenecteplase alone in this specific patient subgroup, while also reflecting an effort to focus on stroke etiologies and imaging findings that exclude major vessel occlusions and cardioembolic sources.