Eligibility CriteriaInclusion criteria
- Symptoms and signs compatible with ischemia in the basilar artery territory.
- Basilar artery occlusion (BAO) confirmed by CTA or MRA.
- Age 18 years or older (i.e., candidates must have had their 18th birthday).
- If IVT is considered as part of best medical management, IVT should be started within 4.5 hours of estimated time of BAO. (Estimated time of BAO is defined as time of onset of acute symptoms leading to clinical diagnosis of BAO or if not known last time patient was seen normal prior to onset of these symptoms).
- Initiation of IAT should be feasible within 6 hours of estimated time of BAO.
- Pre-existing dependency with mRankin ≥3.
- Females of childbearing potential who are known to be pregnant and/or lactating or who have positive pregnancy tests on admission.
- Patients who require hemodialysis or peritoneal dialysis.
- Other serious, advanced, or terminal illness.
- Any other condition that the investigator feels would pose a significant hazard to the patient if thrombolytic therapy is initiated.
- Current participation in another research drug treatment protocol (patient cannot start another experimental agent until after 90 days).
- Informed consent is not or cannot be obtained.
Imaging exclusion criteria
- High-density lesion consistent with hemorrhage of any degree.
- Significant cerebellar mass effect or acute hydrocephalus.
- Bilateral extended brainstem ischemia.