SynthesisNeurosurgical review2025
Endovascular thrombectomy for distal medium vessel occlusion stroke: A meta-analysis of randomized controlled trials.
Synthesis in Neurosurgical review, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 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
3 citing papers in PubMed.
- MeVO: To Treat or Not To Treat? Review of the Latest Evidence.Current neurology and neuroscience reports · 2026Review
- Rethinking reperfusion metrics in endovascular stroke therapy: the limitations of mTICI and a path forward toward more meaningful outcomes.Neuroradiology · 2026Article
- A treatment-response framework for interpreting endovascular thrombectomy evidence: established practice, boundary expansion and unresolved frontiers.Frontiers in neurology · 2026Review
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) resulting from distal medium vessel occlusion (DMVO) remains uncertain. This systematic review and meta-analysis aimed to provide a comprehensive assessment of EVT in AIS due to DMVO, based on evidence derived from randomized controlled trials (RCTs). We systematically reviewed four electronic databases to find relevant studies. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated for categorical and continuous outcomes, respectively. Significant heterogenicity was resolved with leave-one-out influence analysis. There were 601 patients in the EVT plus best medical treatment (BMT) group and 623 patients in the BMT alone group. Findings showed a significantly higher rate of serious adverse events (RR = 1.3, 95%CI: 1.1-1.5, P < 0.01) and symptomatic intracranial hemorrhage (RR = 3.3, 95%CI: 1.8-5.9, P < 0.01) in thrombectomy than the control group. There was no significant difference between two groups in 90-day functional excellence (mRS 0-1), functional independence (mRS 0-2), and mortality. Subgroup analysis, including the three DMVO trials and the two secondary analyses of previous LVO RCTs, confirmed the prior findings. Leave-one-out influence analysis showed no significant heterogeneity in any primary and secondary outcomes. Our findings indicate that while EVT does not provide a significant advantage over BMT alone in improving functional outcomes for patients with DMVO, it is associated with an increased risk of hemorrhagic complications. These results underscore the importance of a cautious approach when considering EVT for DMVO and emphasize the need for further RCTs to optimize treatment strategies.
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Registered trials
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