Endovascular treatment for acute basilar artery stroke with a large infarct core

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This is a multicenter, prospective, open-label, blinded-endpoint randomized controlled trial comparing best medical management (BMM) plus endovascular treatment (EVT) versus BMM alone. Adults with basilar or qualifying vertebral artery occlusion, NIHSS ≥10, and a large posterior-circulation infarct core meeting pc‑ASPECTS criteria within 24 hours of last known well are randomized 1:1 by a centralized simple randomization. Treating teams know the assigned therapy while outcomes are adjudicated blinded to reduce bias. The trial focuses on neurological outcomes and safety of adding EVT in this high-risk population.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* 1\. Age ≥18 years. 2. Symptoms and signs consistent with basilar artery ischemia. 3. Basilar artery or vertebral artery occlusion confirmed by computed tomography angiography (CTA), magnetic resonance angiography (MRA), digital subtraction angiography (DSA); if vertebral artery occlusion is present, it must completely obstruct blood flow to the basilar artery.

  4\. POST-NIHSS score ≥10 at randomization. 5. Time from symptom onset to randomization ≤24 hours (symptom onset defined as last known well time).

  6\. pc-ASPECTS of 3-5 on CT/MRI (for patients aged \<80 years) or pc-ASPECTS of 3-7 (for patients aged ≥80 years).

  7\. Willingness of the patient or legally authorized representative to comply with protocol requirements and data collection procedures, with documented informed consent.

Exclusion Criteria:

* 1\. Pre-stroke modified Rankin Scale (mRS) score \>2. 2. Factors in the target vessel that are expected to prevent completion of endovascular treatment.

  3\. Concurrent anterior and posterior circulation strokes or multivessel occlusions.

  4\. Significant mass effect with imaging or clinical signs of obstructive hydrocephalus or tonsillar herniation.

  5\. Basilar artery occlusion confirmed as chronic by prior imaging or investigator judgment.

  6\. Presence of untreated intracranial aneurysms, intracranial tumors (except small meningiomas), or intracranial vascular malformations.

  7\. Intracranial hemorrhage within the past 6 months, including parenchymal brain hemorrhage, intraventricular hemorrhage, or subarachnoid hemorrhage.

  8\. Presence of active bleeding, coagulation disorders, or uncorrectable bleeding tendencies.

  9\. Severe heart, liver, or kidney dysfunction or other severe systemic late-stage diseases.

  10\. Known allergy to iodine contrast agents or other treatment-related drugs. 11. Medically uncontrolled refractory hypertension (defined as persistent systolic blood pressure \>185 mmHg or diastolic blood pressure \>110 mmHg) (Note: Participants can be included if their blood pressure is controllable with medication and maintained at an acceptable level).

  12\. Uncontrollable blood glucose \<2.8 mmol/L or \>22.2 mmol/L. 13. Pregnancy or breastfeeding. 14. Life expectancy \<6 months. 15. Participation in other clinical studies that may affect outcome assessment. 16. Investigator's judgment that the patient is unsuitable for participation in this study or may face significant risks (e.g., due to mental illness, cognitive, or emotional disorders preventing understanding and/or compliance with study procedures and/or follow-up).

Where it's running

• The First Affiliated Hospital of the University of Science and Technology of China
  Hefei, Anhui, China Recruiting
• First Affiliated Hospital of Hainan Medical University
  Haikou, Hainan, China Recruiting

Study contacts

• Study coordinator: Zhengqiang Zhao, PhD
• Email: zhenqiang.zhao@qq.com
• Phone: 8613976015677

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Endovascular Therapy for Basilar Artery Occlusion With Large Ischemic Core

  This trial tests whether adding endovascular therapy to standard medical care helps people with acute basilar artery occlusion and a large area of brain already affected.

  Recruiting The First Affiliated Hospital of University of Science and Technology of China · Hefei, Anhui · NCT07672795

• Basilar artery occlusion with large brain infarct: real-world endovascular vs medical therapy

  This registry follows adults with basilar artery occlusion and a large core infarct to see how endovascular therapy compares to medical management in routine care.

  Recruiting Xuanwu Hospital, Beijing · Beijing, Beijing Municipality · NCT07345702

• Mobilisation After Endovascular Stroke Treatment

  This study checks whether moving around 12 hours after endovascular stroke treatment is as safe as moving around 24 hours for people with an acute ischemic stroke.

  Recruiting at 2 sites Karolinska Institutet · Tampere and 1 other locations · NCT07860333

• Tenecteplase before transfer for basilar artery stroke 4.5–24 hours after symptom onset

  This trial tests whether giving IV tenecteplase before transfer helps people with basilar artery occlusion who are 4.5–24 hours from symptom onset and are being sent for thrombectomy.

  Recruiting Phase 4 Xuanwu Hospital, Beijing · Beijing · NCT07203625

• Rescue treatment for mild ischemic stroke with basilar artery blockage

  This study is testing if combining a new type of treatment with standard care can help people with mild strokes caused by a blocked basilar artery feel better and recover more effectively.

  Recruiting at 2 sites First Affiliated Hospital of Wannan Medical College · Hefei, Anhui and 1 other locations · NCT06843356

• Comparing two methods for treating stroke caused by basilar artery blockage

  This study is testing two different methods for removing blood clots in the brain to see which one helps adults with stroke caused by a blocked basilar artery recover better.

  Recruiting at 4 sites Hopital Foch · Bordeaux and 11 other locations · NCT05320263

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.