ArticleStroke (Hoboken, N.J.)2026
Endovascular Treatment for Medium and Distal Vessel Occlusion Stroke: Are We Missing the Point?
Article in Stroke (Hoboken, N.J.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Navigating the Complexity and Heterogeneity of Thrombectomy Decision-Making for Medium-Vessel Occlusion Stroke: Where Do We Go From Here?Stroke (Hoboken, N.J.) · 2026Review
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent randomized controlled trials of endovascular treatment (EVT) for distal and medium vessel occlusion (DMVO) stroke did not demonstrate clinical benefit over best medical therapy and suggested potential safety concerns. We aimed to compare baseline characteristics of patients with DMVO stroke enrolled in these trials with those treated with EVT in routine clinical practice (RCP).
methodsWe conducted a retrospective cohort study of a prospectively recorded dual-center database including all consecutive patients with an acute ischemic stroke due to isolated primary DMVO (distal or nondominant M2, M3, A1, A2, A3, P1, P2) between January 2022 and July 2024 who fulfilled trials inclusion/exclusion criteria. Both centers participated in the DMVO trials during the study period. Patients were categorized in 2 groups: those who underwent EVT under RCP (RCP group) versus those randomized in a trial for DMVO stroke (clinical trial, computed tomography group). The 2 groups were evaluated and compared based on demographic, clinical, imaging, and treatment characteristics.
resultsAmong 182 patients (median age, 79 years; interquartile range [IQR], 69-86; 46.2% female), 53 (29.1%) were included in a trial, and 129 (70.9%) were treated in RCP. Compared with RCP patients, those in the computed tomography group presented lower baseline stroke severity (median NIHSS, 5 [IQR, 4-7] versus 10 [IQR,7-15];
conclusionsIn our study, conducted at 2 centers participating in DMVO clinical trials, randomized patients presented milder clinical severity and smaller hypoperfusion areas compared with those treated in daily practice, suggesting a potential selection bias. Our findings highlight the importance of consecutive recruitment in future DMVO trials to clarify the role of EVT.
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