title: Acute basilar artery occlusion: Endovascular Interventions versus Standard Medical Treatment (BEST) Trial-Design and protocol for a randomized, controlled, multicenter study.
abstract: Rationale Endovascular treatment plus standard medical therapy is superior to standard medical therapy alone for acute anterior proximal intracranial large artery occlusion strokes. The benefit of endovascular treatment in acute ischemic stroke caused by basilar artery occlusion remains unproven. Aim This study compares the safety and efficacy of endovascular treatment plus standard medical therapy versus standard medical therapy alone in acute ischemic stroke due to basilar artery occlusion. Design The study is a multicenter randomized control trial with blinded outcome assessment. A projected total 344 subjects with acute basilar arterial occlusion within 8 h of estimated occlusion time will be enrolled over three years in China. Patients will be assigned to endovascular treatment plus standard medical therapy and standard medical therapy alone group in 1:1 ratio for study centers. Study outcomes The primary outcome measure is a favorable functional outcome, defined as a modified Rankin Score of 0-3 at 90 days. The primary safety measure is mortality at 90 days. Trial registration ClinicalTrials.gov (NCT 02441556). Summary The BEST trial will provide valuable insights into the safety and efficacy of endovascular treatment for acute ischemic stroke patients with basilar artery occlusion.
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.affiliation: 2 Department of Medical Statistics, Jinling Hospital, Nanjing, China.
authors.forename: Yuxiu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Wusheng
authors.initials: W
authors.lastname: Zhu
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Minmin
authors.initials: M
authors.lastname: Ma
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Zi
authors.affiliation: 1 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
authors.forename: Qiliang
authors.initials: Q
authors.lastname: Dai
authors.affiliation: 3 Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Thomas
authors.initials: T
authors.lastname: Leung
authors.affiliation: 4 Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Bernard
authors.initials: B
authors.lastname: Yan
authors.affiliation: 4 Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Davis
authors.affiliation: 5 Neurovascular Imaging Research Core and UCLA Stroke Center, Department of Neurology, University of California, Los Angeles, CA, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Liebeskind
authors.affiliation: 6 Department of Medical Imaging and Surgery, Toronto Western Hospital, University of Toronto, Toronto, Canada.
authors.forename: Vítor M
authors.initials: VM
authors.lastname: Pereira
authors.affiliation: 7 Department of Neurology, Neurosurgery and Radiology, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Raul G
authors.initials: RG
authors.lastname: Nogueira
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D018450:Disease Progression; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012107:Research Design; D020521:Stroke / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D016019:Survival Analysis; D017131:Thrombectomy; D014715:Vertebrobasilar Insufficiency / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D055815:Young Adult
keywords: Thrombectomy; basilar artery; endovascular treatment; randomized; stroke