Combination of Hypothermia and Thrombectomy in Acute Stroke

Inclusion Criteria: * Pre-stroke modified Rankin Scale (mRS) 0-2 \[7-point scale rating from 0 (no symptoms) to 6 (dead)\] * Acute ischemic stroke with NIHSS \>5 * Intracranial occlusion of the M1 or M2 segment of the middle cerebral artery (MCA) or internal carotid artery (ICA) or tandem occlusion on CT-angiography or MR-angiography with indication for endovascular treatment: * Time window 0-24h: 1. Last seen normal to groin puncture \< 6h: native CT or MRI-DWI with ASPECTS \>5 2. Last seen normal to groin puncture 6-24h or unknown time window: significant mismatch imaging according to the eligibility criteria of the DEFUSE-3 trial * Infarct core \<70ml (DWI oder CBF\<30%) * Penumbra \> 15ml (Tmax \>6sec) * Ratio penumbra/core \>1.8 * with or without iv thrombolysis with rtPA Exclusion Criteria: * Patients with an intranasal obstruction that prevents complete insertion of the nasal cannula should not be treated with the RhinoChill system. * Known severe hemorrhagic diathesis (International Normalized Ratio (INR) \>3.0, partial thromboplastin time (PTT) \> 70s, platelet count \< 50.000/μl) * Brain trauma or neurovascular surgery/intervention \<3 months * Severe infection * Pregnant women or women of childbearing potential (women of childbearing potential with negative pregnancy test may be included) * Known cerebral vasculitis * Proof of bleeding in cerebral CT or MRI (cerebral microbleeds in MRI \[hypertensive or in the context of cerebral amyloid angiopathy\] is permitted). * Known life expectancy \< 6 months