Tenecteplase Before Interhospital Transfer in Acute Basilar Artery Occlusion at 4.5 to 24 Hours

Inclusion Criteria: * Age ≥18 years; * Patients presenting with posterior circulation ischemic stroke symptoms due to BAO; * BAO confirmed by computed tomographic angiography (CTA)/ magnetic resonance angiography (MRA); * Time from AIS symptom onset to randomization within 4.5-24 hours, stroke onset is defined as the onset of acute symptoms leading to the clinical diagnosis of basilar artery occlusion (BAO) not considering the time of any preceding minor prodromal symptoms (such as isolated vertigo, diplopia or sensory changes) as onset time or, if not known, the time the patient was last known to be well (including wake-up stroke and unwitnessed stroke); * Baseline National Institute of Health Stroke Scale (NIHSS) score obtained prior to randomization ≥6; * Functionally independent (modified Rankin Scale \[mRS\] 0-2) prior to stroke onset; * Intended to transfer for thrombectomy. Two paradigms are allowed in this study: (1)transferring patients to ECC (patient transfer); (2)travelling neurointerventionist to nECC (physician transfer); * Written informed consent from patients or legally responsible representatives Exclusion Criteria: * Posterior Circulation Acute Stroke Prognosis Early CT score (PC-ASPECTS) \< 6 on computed tomography (CT)/CTA-Source Images/MRI with diffusion-weighted imaging (DWI) * CT/MR shows evidence of intracranial hemorrhage and tumor (except small meningioma) * Complete cerebellar infarct on CT/MRI with significant mass effect and compression of the…