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Accurate and dynamic visualization of vascular diseases can contribute to restraining further deterioration from diseases in a timely manner. However, visualization is still unable to precisely determine whether and to what extent blood vessels or brain tissues are damaged. Here, we report novel benzo-bis(1,2,5-thiadiazole)-based second near-infrared region (NIR-II) fluorophores HY1–HY4 with highly twisted structures (55° at the S₀ state), extremely strong aggregation-induced emission (AIE) characteristics (I/I₀ > 13), and remarkably high fluorescence quantum yields (QYs) (up to 14.45%) in the NIR-II region (>1000 nm) and ∼0.27% in the near-infrared IIb window (NIR-IIb, >1500 nm) in aqueous solution. Using NIR-IIb AIE HY4 dots, high-resolution NIR-IIb fluorescence imaging of revascularization and thrombolysis, and real-time feedback of the therapeutic efficacy of Chinese medicine Dengzhan Xixin injection …