Basilar Artery International Cooperation Study

NCT ID: NCT01717755

Last Updated: 2018-01-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

282 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-10-31

Study Completion Date

2020-01-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Rationale: Recently our study group reported the results of the Basilar Artery International Cooperation Study (BASICS), a prospective registry of patients with an acute symptomatic basilar artery occlusion (BAO). Our observations in the BASICS registry underscore that we continue to lack a proven treatment modality for patients with an acute BAO and that current clinical practice varies widely. Furthermore, the often-held assumption that intra-arterial thrombolysis (IAT) is superior to intravenous thrombolysis (IVT) in patients with an acute symptomatic BAO is challenged by our data. The BASICS registry was observational and has all the limitations of a non-randomised study. Interpretation of results is hampered by the lack of a standard treatment protocol for all patients who entered the study.

Objective: Evaluate the efficacy and safety of IAT in addition to best medical management (BMM) in patients with basilar artery occlusion.

Study design: Randomised, multi-centre, open label, controlled phase III, treatment trial.

Study population: Patients, aged 18 years and older, with CTA or MRA confirmed basilar occlusion.

Intervention: Patients will be randomised between BMM with additional IAT versus BMM alone. IAT has to be initiated within 6 hours from estimated time of BAO. If treated with as part of BMM, IVT should be started within 4.5 hours of estimated time of BAO.

Main study parameters/endpoints: Favorable outcome at day 90 defined as a modified Rankin Score (mRS - functional scale) of 0-3.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Basilar Artery Thrombosis Basilar Artery Embolism Stroke of Basilar Artery Stroke Cerebrovascular Disorders Basilar Artery Occlusion

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Best medical management.

Best medical management consists of the standard of care of patients with acute ischemic stroke according to existing local protocols and guidelines, and may include IV thrombolysis.

If treated with IVT as part of BMM, IVT should be started within 4.5 hours of estimated time of BAO.

Group Type NO_INTERVENTION

No interventions assigned to this group

Additional intra-arterial treatment.

Best medical management followed by intra-arterial treatment and best medical management

Group Type EXPERIMENTAL

Intra-arterial treatment

Intervention Type OTHER

IA therapy has to be initiated within 6 hours of estimated time of basilar artery occlusion. If an appropriate thrombus or residual stenosis is identified, the choice of IA strategy wil be made by the treating neurointerventionalist. Choice of therapy depends on local approval and experience. If IA thrombolysis is the chosen strategy, a maximum of 22 mg of IA rt-PA or 1.500.000 Units of Urokinase may be given. Stenting is allowed in the presence of a high-grade vertebral artery stenosis or occlusion hampering adequate endovascular access to the basilar artery and in case of a residual high-grade basilar artery stenosis. The use of any other treatment strategy depends on local approval and experience, and is only allowed after prior approval of the steering committee.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Intra-arterial treatment

IA therapy has to be initiated within 6 hours of estimated time of basilar artery occlusion. If an appropriate thrombus or residual stenosis is identified, the choice of IA strategy wil be made by the treating neurointerventionalist. Choice of therapy depends on local approval and experience. If IA thrombolysis is the chosen strategy, a maximum of 22 mg of IA rt-PA or 1.500.000 Units of Urokinase may be given. Stenting is allowed in the presence of a high-grade vertebral artery stenosis or occlusion hampering adequate endovascular access to the basilar artery and in case of a residual high-grade basilar artery stenosis. The use of any other treatment strategy depends on local approval and experience, and is only allowed after prior approval of the steering committee.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion 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.

Exclusion Criteria

* 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.


* High-density lesion consistent with hemorrhage of any degree.
* Significant cerebellar mass effect or acute hydrocephalus.
* Bilateral extended brainstem ischemia.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

BASICS Study Group

UNKNOWN

Sponsor Role collaborator

Erik van der Hoeven

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Erik van der Hoeven

E.J.R.J. van der Hoeven, MD

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

W J Schonewille, MD

Role: PRINCIPAL_INVESTIGATOR

St. Antonius Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Fortaleza General Hospital

Fortaleza, , Brazil

Site Status RECRUITING

Hospital das Clinicas de Ribeirao Preto

Ribeirão Preto, , Brazil

Site Status RECRUITING

Klinikum Augsburg

Augsburg, , Germany

Site Status RECRUITING

Berlin Charite Hospital

Berlin, , Germany

Site Status RECRUITING

Dresden University Hospital

Dresden, , Germany

Site Status RECRUITING

University Medical Center Mannheim

Mannheim, , Germany

Site Status TERMINATED

Oberschwabenklinik

Ravensburg, , Germany

Site Status TERMINATED

Bergamo Hospital

Bergamo, , Italy

Site Status RECRUITING

Genova Hospital

Genoa, , Italy

Site Status RECRUITING

University Hospital Modena

Modena, , Italy

Site Status RECRUITING

Santa Corona Hospital

Pietra Ligure, , Italy

Site Status RECRUITING

Roma Umberto I

Rome, , Italy

Site Status WITHDRAWN

Varese Hospital

Varese, , Italy

Site Status RECRUITING

Rijnstate

Arnhem, Gelderland, Netherlands

Site Status SUSPENDED

Academic Hospital Maastricht

Maastricht, Limburg, Netherlands

Site Status RECRUITING

St. Elisabeth Hospital

Tilburg, North Brabant, Netherlands

Site Status RECRUITING

Academic Medical Center

Amsterdam, North Holland, Netherlands

Site Status RECRUITING

MCH Westeinde

The Hague, South Holland, Netherlands

Site Status RECRUITING

St. Antonius Hospital

Nieuwegein, Utrecht, Netherlands

Site Status RECRUITING

University Medical Center Groningen

Groningen, , Netherlands

Site Status WITHDRAWN

Leiden University Hospital

Leiden, , Netherlands

Site Status RECRUITING

Erasmus Medical Center

Rotterdam, , Netherlands

Site Status RECRUITING

Haga Hospital

The Hague, , Netherlands

Site Status RECRUITING

Universitary Medical Center Utrecht

Utrecht, , Netherlands

Site Status RECRUITING

University Hospital North Norway

Tromsø, , Norway

Site Status RECRUITING

St. Olavs Hospital Trondheim

Trondheim, , Norway

Site Status RECRUITING

University Hospital of Lausanne

Lausanne, Canton of Vaud, Switzerland

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Brazil Germany Italy Netherlands Norway Switzerland

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Wouter Schonewille, MD

Role: CONTACT

+31 6 41285149

Erik van der Hoeven, MD

Role: CONTACT

+31 6 47490060

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

F Mont Alverne

Role: primary

O Pontes Neto

Role: primary

Hauke Schneider

Role: primary

T. Tassinari

Role: primary

Diederik Dippel

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Schonewille WJ, Wijman CA, Michel P, Rueckert CM, Weimar C, Mattle HP, Engelter ST, Tanne D, Muir KW, Molina CA, Thijs V, Audebert H, Pfefferkorn T, Szabo K, Lindsberg PJ, de Freitas G, Kappelle LJ, Algra A; BASICS study group. Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study. Lancet Neurol. 2009 Aug;8(8):724-30. doi: 10.1016/S1474-4422(09)70173-5. Epub 2009 Jul 3.

Reference Type BACKGROUND
PMID: 19577962 (View on PubMed)

Greving JP, Schonewille WJ, Wijman CA, Michel P, Kappelle LJ, Algra A; BASICS Study Group. Predicting outcome after acute basilar artery occlusion based on admission characteristics. Neurology. 2012 Apr 3;78(14):1058-63. doi: 10.1212/WNL.0b013e31824e8f40. Epub 2012 Mar 21.

Reference Type BACKGROUND
PMID: 22442438 (View on PubMed)

Vergouwen MD, Compter A, Tanne D, Engelter ST, Audebert H, Thijs V, de Freitas G, Algra A, Jaap Kappelle L, Schonewille WJ. Outcomes of basilar artery occlusion in patients aged 75 years or older in the Basilar Artery International Cooperation Study. J Neurol. 2012 Nov;259(11):2341-6. doi: 10.1007/s00415-012-6498-2. Epub 2012 Apr 18.

Reference Type BACKGROUND
PMID: 22527236 (View on PubMed)

Puetz V, Khomenko A, Hill MD, Dzialowski I, Michel P, Weimar C, Wijman CA, Mattle HP, Engelter ST, Muir KW, Pfefferkorn T, Tanne D, Szabo K, Kappelle LJ, Algra A, von Kummer R, Demchuk AM, Schonewille WJ; Basilar Artery International Cooperation Study (BASICS) Group. Extent of hypoattenuation on CT angiography source images in basilar artery occlusion: prognostic value in the Basilar Artery International Cooperation Study. Stroke. 2011 Dec;42(12):3454-9. doi: 10.1161/STROKEAHA.111.622175. Epub 2011 Sep 29.

Reference Type BACKGROUND
PMID: 21960577 (View on PubMed)

Arnold M, Fischer U, Compter A, Gralla J, Findling O, Mattle HP, Kappelle LJ, Tanne D, Algra A, Schonewille WJ; BASICS Study Group. Acute basilar artery occlusion in the Basilar Artery International Cooperation Study: does gender matter? Stroke. 2010 Nov;41(11):2693-6. doi: 10.1161/STROKEAHA.110.594036. Epub 2010 Oct 14.

Reference Type BACKGROUND
PMID: 20947845 (View on PubMed)

Schonewille WJ, Wijman CA, Michel P, Algra A, Kappelle LJ; BASICS Study Group. The basilar artery international cooperation study (BASICS). Int J Stroke. 2007 Aug;2(3):220-3. doi: 10.1111/j.1747-4949.2007.00145.x.

Reference Type BACKGROUND
PMID: 18705948 (View on PubMed)

Schonewille W, Wijman C, Michel P; BASICS investigators. Treatment and clinical outcome in patients with basilar artery occlusion. Stroke. 2006 Sep;37(9):2206; author reply 2207. doi: 10.1161/01.STR.0000237127.84408.c0. Epub 2006 Aug 10. No abstract available.

Reference Type BACKGROUND
PMID: 16902170 (View on PubMed)

Vergouwen MD, Algra A, Pfefferkorn T, Weimar C, Rueckert CM, Thijs V, Kappelle LJ, Schonewille WJ; Basilar Artery International Cooperation Study (BASICS) Study Group. Time is brain(stem) in basilar artery occlusion. Stroke. 2012 Nov;43(11):3003-6. doi: 10.1161/STROKEAHA.112.666867. Epub 2012 Sep 18.

Reference Type BACKGROUND
PMID: 22989501 (View on PubMed)

Roaldsen MB, Jusufovic M, Berge E, Lindekleiv H. Endovascular thrombectomy and intra-arterial interventions for acute ischaemic stroke. Cochrane Database Syst Rev. 2021 Jun 14;6(6):CD007574. doi: 10.1002/14651858.CD007574.pub3.

Reference Type DERIVED
PMID: 34125952 (View on PubMed)

Langezaal LCM, van der Hoeven EJRJ, Mont'Alverne FJA, de Carvalho JJF, Lima FO, Dippel DWJ, van der Lugt A, Lo RTH, Boiten J, Lycklama A Nijeholt GJ, Staals J, van Zwam WH, Nederkoorn PJ, Majoie CBLM, Gerber JC, Mazighi M, Piotin M, Zini A, Vallone S, Hofmeijer J, Martins SO, Nolte CH, Szabo K, Dias FA, Abud DG, Wermer MJH, Remmers MJM, Schneider H, Rueckert CM, de Laat KF, Yoo AJ, van Doormaal PJ, van Es ACGM, Emmer BJ, Michel P, Puetz V, Audebert HJ, Pontes-Neto OM, Vos JA, Kappelle LJ, Algra A, Schonewille WJ; BASICS Study Group. Endovascular Therapy for Stroke Due to Basilar-Artery Occlusion. N Engl J Med. 2021 May 20;384(20):1910-1920. doi: 10.1056/NEJMoa2030297.

Reference Type DERIVED
PMID: 34010530 (View on PubMed)

van der Hoeven EJ, Schonewille WJ, Vos JA, Algra A, Audebert HJ, Berge E, Ciccone A, Mazighi M, Michel P, Muir KW, Obach V, Puetz V, Wijman CA, Zini A, Kappelle JL; BASICS Study Group. The Basilar Artery International Cooperation Study (BASICS): study protocol for a randomised controlled trial. Trials. 2013 Jul 8;14:200. doi: 10.1186/1745-6215-14-200.

Reference Type DERIVED
PMID: 23835026 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

NHS2010B151

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2010-023507-95

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

NL33550.100.10

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Pilot Study of BAO-G Technique in TAAA Endovascular Repair
NCT06534281 ENROLLING_BY_INVITATION EARLY_PHASE1