Endovascular Therapy for Acute Basilar Artery Occlusion With Large Ischemic Core

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.

NCT Number	NCT07672795
Lead Sponsor	The First Affiliated Hospital of University of Science and Technology of China Collaborators: Dalian Municipal Central Hospital, Linyi People's Hospital, Fujian Zhangzhou hospital, Shanghai Minhang District Central Hospital
Conditions	Acute Ischemic Stroke, Basilar Artery Occlusion, Large Ischemic Core
Enrollment	256 participants
Start Date	2026-08-01
Primary Completion	2029-07-30 (estimated)
Study Completion	2029-12-31 (estimated)
Updated on ClinicalTrials.gov	2026-07-02