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Disclosure of interest: None Poster Session II - ACUTE ISCHEMIC STROKE MANAGEMENT 01.00 - ACUTE ISCHEMIC STROKE MANAGEMENT - 01.02 - ACUTE MANAGEMENT - Thrombolysis or thrombectomy P621 - ESOC25-1482 STRATEGY FOR IMPROVING STROKE TREATMENT RESPONSE (SISTER): A PHASE-2 CLINICAL TRIAL OF TS23, A NOVEL MECHANISM FOR IMPROVING OUTCOMES IN ACUTE ISCHEMIC STROKE Eva Mistry 1 , Jordan Elm 2 , Pamela Plummer 1 , Rebeca Aragon Garcia 1 , Paul Kussie 3 , Ryan Sullivan 3 , Iris Davis 1 , Yasmin Aziz 1 , Vivek Khandwala 1 , Achala Vagal 1 , Noor Sabagha 1 , Joseph Broderick 1 , Guy Reed 3 , Pooja Khatri 1 , Scott Janis 4 1 University of Cincinnati, Cincinnati, United States, 2 Medical University of South Carolina, Charleston, United States, 3 Translational Sciences, Inc., Phoenix, United States, 4 National Institute of Neurological Disorder and Stroke, Bethesda, United States Background and Aims: Plasminogen activators for acute ischemic stroke (AIS) suffer from limitations of a narrow therapeutic window, suboptimal thrombolysis of larger clots, paradoxical microthrombosis, neurotoxic effects and hemorrhage