Endovascular Therapy for Acute Basilar Artery Occlusion With Large Ischemic Core

Starting soon · Not applicable

Conditions studied: Acute Ischemic Stroke, Basilar Artery Occlusion, Large Ischemic Core

In brief

Acute basilar artery occlusion is associated with high mortality and severe disability. Previous randomized trials have demonstrated the benefit of endovascular therapy in selected patients with basilar artery occlusion; however, patients with large ischemic core, commonly defined by low posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), remain underrepresented and the benefit-risk profile of endovascular therapy in this subgroup is uncertain. This prospective, multicenter, randomized, open-label, blinded-endpoint trial will evaluate the efficacy and safety of endovascular therapy plus best medical management compared with best medical management alone in patients with acute basilar artery occlusion within 24 hours from symptom onset or last known well and pc-ASPECTS \<7. Eligible participants will be randomized in a 1:1 ratio to receive endovascular therapy plus best medical management or best medical management alone. The primary outcome is favorable functional outcome, defined as a modified Rankin Scale score of 0 to 3 at 90 days.

Key facts

Study ID

NCT07672795

Run by

The First Affiliated Hospital of University of Science and Technology of China

People needed

256

Starts

2026-08-01

Expected to finish

2029-12-31

Last updated by the study team

2026-07-02

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Clinical symptoms or imaging findings suggestive of acute posterior circulation ischemic stroke.
• Basilar artery occlusion confirmed by CTA, MRA, or DSA.
• Posterior circulation ASPECTS <7 on CT, CTA source images, or MRI-DWI.
• Age 18 to 80 years.
• Time from symptom onset or last known well to randomization within 24 hours.
• Written informed consent obtained from the patient or legally authorized representative.
• Baseline NIHSS score ≥6 before randomization.

You may not qualify if…

• Pre-stroke modified Rankin Scale score ≥3.
• Pregnancy or lactation.
• Known allergy to contrast agents or nickel-titanium alloy.
• Current participation in another clinical trial.
• Systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg that cannot be controlled with antihypertensive therapy.
• Known hereditary or acquired bleeding diathesis, coagulation factor deficiency, or current oral anticoagulant use with INR >1.7.
• Blood glucose <50 mg/dL or >400 mg/dL, platelet count <50 × 10\^9/L, or hematocrit <25%.
• Life expectancy less than 1 year.
• Inability to complete 90-day follow-up.
• Definite history of cerebral vasculitis.
• Pre-existing neurological or psychiatric disorder that may interfere with neurological or functional assessment.
• Intracranial hemorrhage on CT or MRI, except for cerebral microbleeds <5 mm on MRI.
• Vascular tortuosity, anatomical variation, or arterial dissection on CTA, MRA, or DSA that precludes endovascular treatment.
• Intracranial tumor, except for small meningioma.

Full record on ClinicalTrials.gov

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