A Comparison of Contact Aspiration Versus Stent Retriever for Acute Basilar Artery Occlusion

Compare the effectiveness and safety of contact aspiration (CA) and stent retriever (SR) in acute ischemic stroke patients with basilar artery occlusion.

Inclusion Criteria:Age≥18 years;Acute basilar artery occlusion confirmed by CTA/MRA/DSA;Last known well to puncture time≤24 hours;pc-ASPECTS score≥6 points;Baseline NIHSS score≥10 points;Consent to endovascular treatment;Informed consent signed.Clinical Exclusion Criteria:Baseline mRS≥3 points;Known or suspected severe basilar artery stenosis (>70%) or chronic occlusion based on history, imaging, or clinical manifestations;Refractory hypertension that is difficult to be controlled by drugs (defined as persistent systolic blood pressure >185 mmHg or diastolic blood pressure >110 mmHg)Genetic or acquired hemorrhagic tendency, coagulation factor deficiency or on anticoagulant therapy and International Normalized Ratio (INR) > 3.0;Laboratory tests: baseline blood glucose <50mg/dl (2.8mmol/L) or >400mg/dl (22.2mmol/L); Baseline platelet count <50×109/L;Known severe allergy (more severe than skin rash) to contrast agents uncontrolled by medications;Females who are pregnant, or those of childbearing, potential with positive urine or serum beta Human Chorionic Gonadotropin test;Other circumstances that the investigator considers inappropriate for participation in the trial or that may pose significant risks to patients (such as inability to understand and/or follow the study procedures and/or follow up due to mental disorders, cognitive or emotional disorders).Imaging Exclusion Criteria:CT or MR evidence of acute intracranial hemorrhage (the presence of microbleeds on MRI is allowed);Midline shift or herniation, mass effect with effacement of the ventricles;Complete cerebellar infarct on CT or MRI with significant mass effect and compression of the 4-th ventricle;Complete bilateral thalamic infarction on CT or MRI;Inability to endovascular treatment due to Excessive tortuosity, variation, or dissection of the artery;Subjects with occlusions in both intracranial vertebral arteries;Subjects with occlusions in both anterior and posterior circulation;Evidence of intracranial tumor (except small meningioma).