A Randomized Trial Of Endovascular Treatment For Acute Posterior Large Vessel Occlusion

Inclusion Criteria: 1. Age: i. 18 \~ 80 years old, pc-ASPECTS score ≥ 6; ii. \> 80 years old, pc-ASPECTS score ≥ 8 and mRS = 0 before the onset 2. NIHSS score ≥ 10 before randomization; 3. VA-V4 or basilar artery occlusion proved by CTA/MRA/DSA; 4. Time from stroke onset to randomization within 23.5 hours; 5. Written informed consent is obtained from patients and/or their legal representatives. Exclusion Criteria: 1. CT or MR evidence of intracranial hemorrhage; 2. Pre-morbidity with a modified Rankin scale score ≥ 3; 3. The patient is in deep coma; 4. Currently in pregnant or lactating or serum beta HCG test is positive on admission; 5. Arterial tortuosity and/or other arterial disease that would prevent the device from reaching the target vessel; 6. Contraindication to radiographic contrast agents, nickel, titanium metals or their alloys; 7. Significant mass effect in the cerebellar hemisphere or hydrocephalus on imaging; 8. Imaging manifestations of diffuse bilateral brainstem ischemia; 9. Multivessel occlusive disease (combined with anterior and posterior circulation occlusion or subtotal occlusion); 10. Cerebral vasculitis, intracranial arteriovenous malformation, aneurysm, or brain tumor with mass effect; 11. Participating in other clinical trials; 12. Any terminal illness with life expectancy less than 6 months; 13. Patients with a preexisting neurological or psychiatric disease that would confound the neurological functional evaluations; 14. Past neurological or psychiatric diseases that hinder the assessment of neurological function; 15. Unlikely to be available for 90-day follow-up.