Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2024
Reperfusion strategies in stroke with medium-to-distal vessel occlusion: a prospective observational study.
Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Endovascular therapy versus best medical care for acute ischemic stroke with distal medium vessel occlusion: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- Effectiveness and safety of endovascular therapy compared to intravenous thrombolysis in acute ischaemic stroke due to medium-vessel occlusions: a real-world multicentre study from the Italian SITS registry.European stroke journal · 2026Article
- Comparing the Efficacy and Safety of Endovascular Therapy Versus Best Medical Treatment in Acute Ischemic Stroke Patients With Distal Medium Vessel Occlusion: A Systematic Review and Meta-Analysis.Journal of central nervous system disease · 2026Review
- Endovascular Therapy Versus Nonendovascular Therapy for Acute Ischemic Stroke With Distal Medium Vessel Occlusion: A Systematic Review and Meta-Analysis.Stroke (Hoboken, N.J.) · 2026Article
- Demographic and Premorbid Clinical Factors Predict Modified Rankin Score in Large and Medium Vessel Occlusion Ischemic Strokes.Journal of clinical medicine · 2025Article
- Mechanical Thrombectomy Versus Intravenous Thrombolysis in Distal Medium Vessel Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study.Journal of stroke · 2024Article
- Endovascular thrombectomy versus intravenous thrombolysis for primary distal, medium vessel occlusion in acute ischemic stroke.Open medicine (Warsaw, Poland) · 2024Article
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMedium vessel occlusion (MeVO) accounts for 30% of acute ischemic stroke cases. The risk/benefit profile of endovascular thrombectomy (EVT) and intravenous thrombolysis (IVT) or the combination of the two (bridging therapy (BT)) is still unclear in MeVO. Here, we compare reperfusion strategies in MeVO for clinical and radiological outcomes.
methodsThis prospective single center study enrolled consecutive patients with AIS due to primary MeVO undergoing IVT, EVT, or BT at a comprehensive stroke center. Primary outcome was good functional status, defined as modified Rankin Scale (mRS) 0-2 at 3-month follow-up. Additional outcomes included mortality, successful recanalization, defined as mTICI ≥ 2b, stroke severity at discharge, and symptomatic intracerebral hemorrhage (sICH) according to SITS-MOST criteria. Logistic regression was modeled to define independent predictors of the primary outcome.
resultsOverall, 180 consecutive people were enrolled (IVT = 59, EVT = 38, BT = 83), mean age 75. BT emerged as independent predictor of primary outcome (OR = 2.76, 95% CI = 1.08-7.07) together with age (OR = 0.94, 95% CI = 0.9-0.97) and baseline NIHSS (OR = 0.88, 95% CI = 0.81-0.95). BT associated with a 20% relative increase in successful recanalization compared to EVT (74.4 vs 56.4%, p = 0.049). Rates of sICH (1.1%) and procedural complications (vasospasm 4.1%, SAH in 1.7%) were very low, with no difference across groups. DISCUSSION: BT may carry a higher chance of good functional outcome compared to EVT/IVT only in people with AIS due to MeVO, with marginally higher rates of successful recanalization. Randomized trials are needed to define optimal treatment tailoring for MeVO.
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