Here is the design of a clinical trial:

Official Title: Tenecteplase Versus Alteplase for Stroke Thrombolysis Evaluation Trial in the Ambulance

Included conditions:
- Stroke, Acute, Stroke Ischemic

Study Armgroups:
- {'label': 'Intravenous tenecteplase (TNK)', 'type': 'ACTIVE_COMPARATOR', 'description': 'Patients will receive intravenous tenecteplase (0.25mg/kg, maximum 25mg, administered as a bolus over \\~10 seconds).', 'interventionNames': ['Drug: Tenecteplase']}
- {'label': 'Intravenous tissue plasminogen activator (tPA)', 'type': 'ACTIVE_COMPARATOR', 'description': 'Patients will receive intravenous t-PA at the standard licensed dose of 0.9 mg/kg up to a maximum of 90mg, 10% as bolus and the remainder over 1 hour.', 'interventionNames': ['Drug: Intravenous tissue plasminogen activator (tPA)']}

Interventions:
- {'type': 'DRUG', 'name': 'Tenecteplase', 'description': 'Route: IV bolus injection Frequency: once only, within 4.5 hours of stroke onset', 'armGroupLabels': ['Intravenous tenecteplase (TNK)'], 'otherNames': ['TNK']}
- {'type': 'DRUG', 'name': 'Intravenous tissue plasminogen activator (tPA)', 'description': 'Route: Intravenous (IV) infusion (10% as bolus and the remainder over 60 minutes) Frequency: once only, within 4.5 hours of stroke onset', 'armGroupLabels': ['Intravenous tissue plasminogen activator (tPA)'], 'otherNames': ['TPA, Alteplase']}

Primary Outcomes:
- {'measure': 'Perfusion lesion on CTP', 'description': 'The volume of the perfusion lesion on CTP performed on arrival at the receiving hospital, adjusted for pre-treatment NIHSS and time from initiation of treatment to CTP.', 'timeFrame': 'Within 2hrs of treatment'}

Please estimate the sample size based on the assumption: 
90% power, significance level of p=0.05, and a conservative 20% difference in post-treatment perfusion lesion.
Sample size estimates
        Based on the data from the phase II and III Australian tenecteplase trials and experiences with the MSU, an estimated total sample size of 104 patients (with 52 patients in each treatment and control arms) yields 90% power to detect a hypothesised mean difference of 13âmL (SD 20âmL) in the perfusion lesion volume between treatment groups measured at the receiving hospital at a statistical significance threshold of p=0.05. The ongoing TASTE trial has a mean pre-treatment perfusion lesion volume of 65âmL (SD 20âmL). In phase II Australian tenecteplase trial, the post-treatment (24 hours) perfusion lesion was 50% smaller in the tenecteplase arm. Given post-treatment CTP will be performed considerably earlier in TASTE-A, we have assumed a more conservative 20% difference in post-treatment perfusion lesion.10
        Adaptive increase in sample size is planned based on the result of interim analysis using data from the first 80 patients, as per Mehta and Pocock.29 The maximum sample size is capped at 200 patients, with a minimum of 104.
        A blinded review of the perfusion lesion volume was conducted based on the first 80 participants. It revealed that the more appropriate model was a zero-inflated negative binomial (ZINB) regression model with the perfusion volume expressed as a count of millilitres of perfusion lesion. The ZINB model accounts for the potential overdispersion in the perfusion lesion volume distribution and the potential presence of stroke mimics among the RCT participants.
        We performed the sample size re-estimation using the ZINB regression and found no need for an adaptive increase in the sample size. Therefore, the final sample size was 104.