ReviewNeurological research and practice2025
Randomized controlled trials of endovascular therapy for acute ischemic stroke with medium or distal vessel occlusion: a study level metaanalysis.
Review in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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 for stroke due to medium vessel occlusion: a meta-analysis of randomized controlled trials.Annals of medicine and surgery (2012) · 2026Article
- CTA imaging characteristics and endovascular therapy effect in patients with large ischemic stroke: a prospective cohort study.Neurological research and practice · 2026Article
- [Focus on neurological intensive care medicine 2024/2025-Summary of selected studies in intensive care medicineal care].Die Anaesthesiologie · 2026Article
- Endovascular Treatment for Medium and Distal Vessel Occlusion Stroke: Are We Missing the Point?Stroke (Hoboken, N.J.) · 2026Article
- CT perfusion-guided thrombolysis in the extended window: from trial eligibility to individualized patient selection.Frontiers in neurology · 2026Review
- Primary vs. Rescue Medium Vessel Occlusions: Comparative Clinical Outcomes in Patients with Acute Ischemic Stroke.Journal of clinical medicine · 2025Article
- Tailored Treatment of Acute Ischemic Stroke: A Narrative Review of Evidence-Based Strategies by Imaging Type and Thrombectomy Availability.Medicina (Kaunas, Lithuania) · 2025Review
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionA decade ago, endovascular therapy (EVT) for acute ischemic stroke (AIS) with large vessel occlusion (LVO) has been established as standard of care. It is still a matter of debate whether EVT is better and safe for patients with more distal occlusions (DMVO). Three randomized controlled trials investigated the role of EVT on top of best medical treatment (BMT) for patients with DMVO.
methodsIn a narrative review we present the results of 3 randomized controlled trials (RCT), (DISTAL, ESCAPE MeVO, DISCOUNT) of EVT plus BMT versus BMT alone. In addition, we performed a study level meta-analysis with a random-effects model for three endpoints: independent outcome, symptomatic intracranial hemorrhage (sICH) and death.
resultsThere was neither a significant effect of EVT plus BMT versus BMT alone on functional outcome (RR 0.92, 95% CI 0.80-1.06, p = 0.272), nor did the odds of death differ (OR 1.23, 95% CI 0.76-1.99, p = 0.409). The odds for sICH were more than twice as high with EVT (OR 2.38, 95% CI 1.35-4.20, p = 0.003).
conclusionAt present EVT for medium and distal vessel occlusions in AIS patients is not a standard of care. With equipoise for EVT in DMVO now an unbiased and rapid randomization into new and differently designed RCT should be a top priority.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.