Objectire:To explore and evaluate the predictors for the prognosis of acute besilar artery occlusion(BAO)and the clinical efficacy of intra-arterial thrombolysis and stenting for BAO.Methods:Intra-arterial thrombolysis was administered with recombinant tissue plasminogen activator or urokinase in 52 patients with BAO within 3 to 48 hours.Stenting was performed in patients whose partial recanalization of residual stenosis＞50%after the thrombolysis.National Institutes of Health Stroke Scale(NIHSS)score was measured before the procedure,and the modifled Rankin scale(mRS)score was obtained at 3 months after the procedure.The clinical data were evaluated with the multivariable stepwise logistic regression analysis and Fisher's exact test.Results:Complete recanalization achieved in 24 patients(46.2%),partial recanalization in 16 patients(30.7%),and non-recanalization in 12 patients(23.1%).mRS scores:22 patients(42.3%)had a favorable outcome,32 survived(61.5%),and 20 died (38.5%).The prognosis of BAO was significantly correlated with the NIHSS score(P＜0.01),therapeutic time window (P ＜0.05) and recanalization level (after the thrombolysis and stenting)(P＜0.01 );the good recanalization after the intra-arterial thrombolysis was significantly correlated with the NIHSS score (P ＜0.01) and therapeutic time window (P ＜0.05).Multivariate analysis showed that the NIHSS score ＜ 14 (P ＜ 0.01 ) and good recanalization could independently predict the favorable prognosis of BAO.Conclusions:The NIHSS score ＜ 14 and good recanalization were the independent predictors for good prognosis of BAO.The rapid and timely treatment of BAO with intra-arterial thrombolysis and stenting is a safe and effective measure.