Response to: Basilar artery occlusion and unwarranted clinical trials.

In their letter to the editor, the authors from the Karolinska Institute argue that, with the current available evidence of efficacy of mechanical thrombectomy for acute ischemic stroke, it is unethical to perform a trial in patients with basilar artery occlusion in which patients are at risk of being withheld this effective treatment. Good outcomes of a few selected patients after intra-arterial thrombolysis (IAT) were enough evidence for the stroke community to obviate the performance of a randomized trial of patients with basilar artery occlusion. Meta-analysis of retrospectively collected data of case series of selected patients showed no "obvious" difference in outcome between patients treated with intravenous thrombolysis (IVT) or IAT.[4]. [Extracted from the article]