ArticleJAMA2024
Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke: The MARVEL Randomized Clinical Trial.
Article in JAMA, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Efficacy and safety of corticosteroids for stroke and traumatic brain injury: a systematic review and meta-analysis.Systematic reviews · 2025Pooled it
- Adjunctive Methylprednisolone After Thrombectomy: A Secondary Analysis Stratified by Admission White Blood Cell Count.CNS neuroscience & therapeutics · 2026Trial
- Procedure time and clinical outcomes after thrombectomy: a pooled cohort analysis of three randomised trials.European stroke journal · 2026Trial
- Endovascular Treatment for Patients Aged ≥80 Years with Large Ischemic Stroke.Clinical interventions in aging · 2026Trial
- Methylprednisolone as Adjunct to Thrombectomy for Acute Intracranial Internal Carotid Artery Occlusion Stroke: Post Hoc Secondary Analysis of the MARVEL Randomized Clinical Trial.JAMA network open · 2025Trial
- Impact of Asymptomatic Intracranial Hemorrhage on Outcome After Endovascular Stroke Treatment.Annals of clinical and translational neurology · 2026Article
- Article
- Predictors of futile recanalisation in patients with large infarct: a post-hoc analysis of the ANGEL-ASPECT trial.Stroke and vascular neurology · 2026Observational
- Efficacy and safety of minocycline on patients with acute anterior circulation ischaemic stroke undergoing mechanical thrombectomy (MIST-A): a multicentre, prospective, randomised, open-label, blinded-endpoint, phase 2 trial.The Lancet regional health. Western Pacific · 2026Article
- Prognostic Value of the Day 5-7 Neurological Examination in Anterior Circulation Ischemic Stroke: A Post Hoc Analysis of the MARVEL Trial.Neurology and therapy · 2026Article
- Impact of time from symptom onset to recanalization in acute anterior circulation large vessel occlusive stroke with same tissue window: A patient-level pooled analysis of the three randomized controlled trials.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Observational
- Cytoprotection Concepts for Ischemic Stroke in the Recanalization Era.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Review
- The incidence and impact of early post-stroke seizures for successful endovascular stroke treatment: an individual patient data level analysis of trials.International journal of surgery (London, England) · 2026Article
- Efficacy and safety of adjunctive tirofiban administration in anterior large vessel occlusion due to large artery atherosclerosis: an individual patient data pooled analysis of two randomized clinical trials.International journal of surgery (London, England) · 2026Article
- Concurrent Acute Ischemic Stroke and Acute Coronary Syndrome: A Case Report on Sequential Endovascular Intervention and Peri-Procedural Antiplatelet Management with Tirofiban.International medical case reports journal · 2026Article
- Prognostic significance of peripheral immunity after thrombectomy in acute ischemic stroke: a retrospective study stratified by early post-EVT leukocyte count.Frontiers in immunology · 2026Article
- Sex-specific effects of methylprednisolone on outcomes after endovascular treatment for acute ischemic stroke due to large vessel occlusion: A secondary analysis of the MARVEL trial.Therapeutic advances in neurological disorders · 2026Article
- Preoperative exercise tolerance, nutritional-inflammatory markers, and outcomes after TEVAR for type B aortic pathology.Frontiers in cardiovascular medicine · 2026Article
- Microcirculatory failure after successful recanalization in ischemic stroke: insights into mechanisms, imaging, and therapeutic strategies.Frontiers in pharmacology · 2026Review
- Tracing Inflammation in Ischemic Stroke: Biomarkers and Clinical Insight.International journal of molecular sciences · 2025Review
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Authors and funding
71 authors at 20 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective: To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants: This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023. Interventions: Eligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures: The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results: Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance: Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability. Trial Registration: ChiCTR.org.cn Identifier: ChiCTR2100051729.
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