ArticleJournal of neurointerventional surgery2025
Endovascular therapy versus medical management in isolated anterior cerebral artery acute ischemic stroke: a multinational multicenter propensity score-weighted study.
Abstract readMulticenter StudyComparative Study
In one paragraph
Article in Journal of neurointerventional surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
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
7 citing papers in PubMed.
- Endovascular Thrombectomy in Medium and Distal Vessel Occlusions: A Focused Guideline From the Society of Vascular and Interventional Neurology Guidelines and Practice Standards Committee.Stroke (Hoboken, N.J.) · 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
- The Cortical Vein Opacification Score Is Independently Associated with Good and Excellent Functional Outcomes at 90 Days in Patients with Minor Stroke with Anterior Circulation Large-Vessel Occlusion: A Multicenter Study.AJNR. American journal of neuroradiology · 2025Article
- Efficacy and safety of mechanical thrombectomy in distal medium middle cerebral artery occlusion ischemic stroke patients on low-dose aspirin.International journal of stroke : official journal of the International Stroke Society · 2025Article
- Article
- Prolonged Venous Transit Is Associated With Unfavorable Outcomes in Anterior Circulation Distal Medium Vessel Stroke.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
- Earlier endovascular therapy within 24 h of ischemic stroke is associated with attenuated systemic inflammation and better neurological recovery.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
66 authors.
Hamza Adel Salim *Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA hamza.sleeem@gmail.com admytriw@mgh.harvard.edu.ORCID http://orcid.org/0000-0002-5208-8425
Benjamin Pulli *Department of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, California, USA.ORCID http://orcid.org/0000-0002-1795-9897
Vivek Yedavalli *Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA.ORCID http://orcid.org/0000-0002-2450-4014
Fathi MilhemNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.
Basel MusmarDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID http://orcid.org/0009-0000-4910-6090
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, Louisiana, USA.
Dhairya A LakhaniDepartment of Radiology, West Virginia University, Morgantown, West Virginia, USA.ORCID http://orcid.org/0000-0001-7577-1887
Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Albert Einstein College of Medicine, Bronx, New York, USA.ORCID http://orcid.org/0000-0001-8325-2382
Jeremy Josef HeitDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, California, USA.
Tobias D FaizyDepartment of Radiology, Neuroendovascular Program, University Medical Center, Münster, Germany.ORCID http://orcid.org/0000-0002-1631-2020
Kareem El NaamaniDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Nils HenningerDepartment of Neurology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA.ORCID http://orcid.org/0000-0002-3883-5623
Sri Hari SundararajanDepartment of Endovascular Neurosurgery and Neuroradiology NJMS, NJMS, Newark, New Jersey, USA.
Anna Luisa KuhnDepartment of Radiology, Division of Neurointerventional Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA.
Jane KhalifeCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, New Jersey, USA.
Sherief GhozyDepartments of Neurological Surgery & Radiology, Mayo Clinic, Rochester, Minnesota, USA.ORCID http://orcid.org/0000-0001-5629-3023
Luca ScarciaDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.ORCID http://orcid.org/0000-0002-1316-0383
Leonard Ll YeoDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.ORCID http://orcid.org/0000-0002-4249-0402
Benjamin Yq TanDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Robert W RegenhardtNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.
Nicole M CancelliereDivisions of Therapeutic Neuroradiology and Neurosurgery, Neurovascular Centre, St. Michael's Hospital, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-8703-4304
Aymeric RouchaudNeuroradiology Department, University Hospital of Limoges, Limoges, France.ORCID http://orcid.org/0000-0003-0902-3375
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.ORCID http://orcid.org/0000-0001-8533-7478
Sunil A ShethDepartment of Neurology, UTHealth McGovern Medical School, Houston, Texas, USA.ORCID http://orcid.org/0000-0003-0602-8509
Ajit S PuriDepartment of Radiology, Division of Neurointerventional Radiology, University of Massachusetts Medical Center, Worcester, Massachusetts, USA.
Christian DyzmannNeuroradiology Department, Sana Kliniken, Lübeck GmbH, Germany.
Marco ColasurdoDepartment of Interventional Radiology, Oregon Health and Science University, Portland, Oregon, USA.
Leonardo RenieriInterventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
João Pedro FilipeDepartment of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Pablo HarkerDepartment of Neurology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA.
Răzvan Alexandru RaduDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.ORCID http://orcid.org/0000-0001-6375-8466
Mohamad AbdalkaderDepartments of Radiology & Neurology, Boston Medical Center, Boston, Massachusetts, USA.
Piers KleinDepartments of Radiology & Neurology, Boston Medical Center, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0001-7468-137X
Thomas R MarottaDivisions of Therapeutic Neuroradiology and Neurosurgery, Neurovascular Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Julian SpearsDivisions of Therapeutic Neuroradiology and Neurosurgery, Neurovascular Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Takahiro OtaDepartment of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.ORCID http://orcid.org/0000-0002-5108-6719
Ashkan MowlaDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA.
Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.ORCID http://orcid.org/0000-0002-1544-4910
Arundhati BiswasDepartment of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, New York, USA.
Frédéric ClarençonDepartment of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
James E SieglerCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, New Jersey, USA.ORCID http://orcid.org/0000-0003-0287-3967
Thanh N NguyenDepartments of Radiology & Neurology, Boston Medical Center, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0002-2810-1685
Ricardo VarelaDepartment of Neurology, Centro Hospitalar Universitário do Porto, Porto, Portugal.
Amanda BakerDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Albert Einstein College of Medicine, Bronx, New York, USA.
David AltschulDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Albert Einstein College of Medicine, Bronx, New York, USA.ORCID http://orcid.org/0000-0002-5130-1378
Nestor GonzalezDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-8277-6317
Markus A MöhlenbruchSektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Vincent CostalatDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.
Benjamin GoryINSERM U1254, IADI, Université de Lorraine, Lorraine, France.
Paul StrackeDepartment of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Münster, Germany.
Constantin HeckerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria.ORCID http://orcid.org/0000-0003-0521-8570
Gaultier MarnatInterventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.ORCID http://orcid.org/0000-0002-7611-7753
Hamza ShaikhCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, New Jersey, USA.ORCID http://orcid.org/0000-0001-8163-4600
Christoph J GriessenauerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria.ORCID http://orcid.org/0000-0002-2952-3812
David S LiebeskindUCLA Stroke Center and Department of Neurology Department, UCLA, Los Angeles, California, USA.ORCID http://orcid.org/0000-0002-5109-8736
Alessandro PedicelliUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
Andrea Maria AlexandreUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.ORCID http://orcid.org/0000-0002-8080-3916
Illario TancrediDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Erwah KalsoumDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.ORCID http://orcid.org/0000-0002-8575-0606
Boris LubiczDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Aman B PatelNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA.
Vitor Mendes PereiraDivisions of Therapeutic Neuroradiology and Neurosurgery, Neurovascular Centre, St. Michael's Hospital, Toronto, Ontario, Canada.ORCID http://orcid.org/0000-0002-6804-3985
Max WintermarkDepartment of Neuroradiology, MD Anderson Medical Center, Houston, Texas, USA.
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.ORCID http://orcid.org/0000-0001-7281-1652
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, Massachusetts, USA hamza.sleeem@gmail.com admytriw@mgh.harvard.edu.ORCID http://orcid.org/0000-0003-0131-5699
MAD-MT Investigators
Funding
West Virginia IDEA-CTRU54GM104942 · NIGMS · WEST VIRGINIA UNIVERSITY · PI Sally Lynn Hodder · 2012 to 2026
$81.0MStatistical Methods to Jointly Model Multiple Pain Outcome MeasuresU24NS113844 · NINDS · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI TROXEL, ANDREA B, YU, CHANG · 2019 to 2024
$25.9MImproving patient care in severe acute brain injury: a web/mobile/tablet-based communication and decision support tool for clinicians and families in the neuro-ICUR21NR020231 · NINR · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI HENNINGER, NILS, MUEHLSCHLEGEL, SUSANNE · 2022 to 2023
$461kRole of Sarm1 in TBI-accentuated C9orf72 Frontotemporal DementiaR21NS131756 · NINDS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI HENNINGER, NILS · 2023 to 2024
$461kNIGMS NIH HHS U54 GM104942NINDS NIH HHS R21 NS131756NINDS NIH HHS U24 NS113844NINR NIH HHS R21 NR020231
Abstract
backgroundIsolated anterior cerebral artery occlusions (ACAo) in patients with acute ischemic stroke present significant challenges due to their rarity. The efficacy and safety of endovascular therapy (EVT) in comparison with best medical therapy (BMT) for ACAo remains unclear. This study aimed to assess the outcomes of these treatments.
methodsThis multinational, multicenter study analyzed data from the MAD-MT registry. Data were collected retrospectively from 37 sites across North America, Asia, and Europe. Inverse probability of treatment weighting (IPTW) was applied to balance confounding variables. The primary outcome was functional independence (modified Rankin Scale (mRS) scores of 0-2) at 90 days. Secondary outcomes included excellent outcomes (mRS 0-1), mortality at 90 days, and NIH Stroke Scale (NIHSS) score on day 1 post treatment.
resultsOf the 108 patients, 36 received BMT and 72 underwent EVT. The median age was 75 years, and 56% were male. At 90 days, 40% of patients achieved mRS 0-2, with no significant difference between EVT and BMT (38% vs 45%, p=0.46). Procedural success (mTICI 2b-3) was 91% in the EVT group, with a sICH rate of 2.9%. IPTW-adjusted analysis showed no significant difference between EVT and BMT for functional independence (OR 1.17, 95% CI 0.23 to 6.02, p=0.85), mortality (25% vs 21%, p=0.71) or day 1 NIHSS scores (Beta 2.2, 95% CI -0.51 to 4.8, p=0.11).
conclusionsEVT showed high procedural success but did not significantly improve functional outcomes or mortality compared with BMT in patients with ACAo. Further randomized trials are needed to clarify EVT's role in ACAo.
Indexed as
Endovascular ProceduresInfarction, Anterior Cerebral ArteryIschemic StrokePropensity ScoreAgedAged, 80 and overFemaleHumansMaleMiddle AgedRegistriesRetrospective StudiesTreatment OutcomeStroke
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