Improving Neurological Outcome for Acute Basilar Artery Occlusion With Sufficient Recanalization After Thrombectomy by Intraarterial Tenecteplase (INSIST-IT)

Inclusion Criteria: * Age ≥ 18 * Patients with basilar artery occlusion who received endovascular treatment within 24 hours of estimated time of stroke onset as per BASICS trial definition; * National Institute of Health Stroke Scale (NIHSS) ≥ 6 before endovascular treatment; * Successful recanalization (mTICI 2b-3) after endovascular treatment; * PC-ASPECTS ≥ 6 on CT; * Absence of parenchymal hematoma on CT images done in the angio suite immediately after the procedure; * Modified Rankin Scale score before stroke onset ≤ 3; * Signed informed consent by patient or their legally authorized representative. Exclusion Criteria: * baseline PC ASPECTS \< 5 on CT; * More than six retrieval attempts in the same vessel; * Hemorrhagic stroke: cerebral hemorrhage, subarachnoid hemorrhage; * Coagulation disorders, systemic hemorrhagic diathesis, thrombocytopenia (\<100000/mm3), or INR \> 1.7; * Severe hepatic or renal dysfunction, increase in ALT or AST (more than 2 times of upper limit of normal value), increase in serum creatinine (more than 1.5 times of upper limit of normal value) or requiring dialysis; * After recanalization, severe and sustained (i.e., \> 5 minutes) uncontrolled hypertension (systolic blood pressure over 180mmHg or diastolic blood pressure over 105 mmHg) refractory to antihypertensive medication; * Patients with contraindication or allergic to any ingredient of drugs in our study * Pregnancy, plan to get pregnant or during lactation * The estimated life expectan…